Eli's Rehab Report

Question: When a physician tests four nerves bilaterally, how should I code the nerve conduction study: 95903-LT x 4 units and 95903-RT x 4 units, or 95903-50 x 8 units?


South Dakota Subscriber


Answer: The code for motor nerve conduction with F-wave study carries a  "0" indicator for bilateral services in the 2004 RBRVS, which means that bilateral is not applicable for this code. 

Due to the quantity of nerves tested, rather than billing out one line item with eight units in 24G (a quantity that most payers would not reimburse without appeal), try separating them out into two line items, such as 95903-LT (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study; left side) x 4 units and 95903-RT (... right side) x 4 units. The -RT and -LT modifiers will indicate to the payer that your physician did perform four on each side.
 
Be sure to have your documentation readily available because many payers still balk at reimbursing this number of motor nerve tests. They'll want to ensure that each nerve tested is separate by definition.

 - You Be the Coder and Reader Questions were reviewed by Marvel Hammer, RN, CPC, CCS-P, CHCO, owner of MJH Consulting in Denver.