Pain Management Coding Alert
Coding Both Parts of EDX Test
Question: I have a confusing claim in front of me. Encounter notes indicate that the physician performed a 14-part nerve conduction study (NCS) and a limited electromyography (EMG) for the same patient during the same session. The patient was suspected of suffering from traumatic nerve lesions. Is there a single code for this service, or do I need to report multiple codes?
Texas Subscriber
Answer: This service is most likely electrodiagnostic (EDX) testing, which occurs when your provider performs an NCS in combination with an EMG. If the tests occurred during the same encounter, it’s virtually certain that this was an EDX service. If you have any doubt as to whether the physician performed a complete EDX, check with her before filing the claim.
For the NCS, you’d report 95913 (Nerve conduction studies; 13 or more studies). For the EMG, opt for 95885 (Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited [List separately in addition to code for primary procedure]).
Caveat: The 95885 code is an add-on code, and you must report it along with a primary code; in this scenario, the primary code is 95913. You should never, under any circumstances, report 95885 as a primary code.
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