Eli's Rehab Report
Don't Forget EMG Guidance With Myobloc Injections
If you perform electromyographic (EMG) guidance to ensure Botox injection needle placement, most payers will reimburse the EMG codes separately - and if you're not reporting these services, you're selling your services short. Select EMG Codes by Location Select the appropriate EMG code based on the injection site. For example, if the physiatrist provides an injection to one arm under guidance, report 95860 in addition to the code for the injection and supplies, says Marvel J. Hammer, RN, CPC, CHCO, owner of MJH Consulting, a healthcare reimbursement consulting firm in Denver. But if he provides injections under guidance bilaterally, report 95861, she says.
Each Medicare carrier and private insurer provides its own list of allowable EMG codes, so you should check with your payer prior to reporting these procedures. The most commonly used codes include:
Most insurers will reimburse an E/M service on the same date as a Botox injection as long as the physician provides a significant and separately identifiable evaluation and you append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the E/M code, says Barbara Cobuzzi, MBA, CPC, CPC-H, CHBME, president of Cash Flow Solutions Inc., a reimbursement consulting firm located in Brick, N.J.
For instance, a cervical dystonia patient arrives for her Myobloc injection, complaining of pain in her neck at the previous injection site. The physiatrist suspects an infection and performs a level-two evaluation of the patient, only to find that the patient has minor neck bruising at the prior injection site but no infection. He then administers 2,500 units of Myobloc via injection. You should report the encounter as follows:
Eli's Rehab Report
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