Eli's Rehab Report

Question: How should I report an EMG study of muscles supplied by the cranial nerve?


Michigan Subscriber

Answer: You'll find two codes that describe an EMG study of muscles supplied by the cranial nerve, either unilaterally or bilaterally, respectively:

• 95867 -- Needle electromyography; cranial nerve supplied muscle(s), unilateral
• 95868 -- ... cranial nerve supplied muscles, bilateral.

Heads-up: Because a bilateral procedure includes a unilateral procedure, don't make the mistake of reporting 95867 and 95868 at the same time. Also, don't attach modifier 50 (Bilateral procedure) to either 95867 (because a bilateral code already exists) or 95868 (because it already specifies "bilateral").

For example, a physiatrist performs an EMG to diagnose possible motor neuron disease (335.2x). He studies the motor neurons on one side of the face to evaluate possible muscle weakness and wasting. Then he repeats the procedure on the other side to provide a comparison so that he may diagnose Bell's palsy (351.0) or other disorders. In this case, you should use 95868.

Important: Because you're in Michigan, you'll have to make sure a licensed physician performs the needle EMG and any interpretation of nerve conduction studies.  According to the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM), Michigan is the first state to pass this patient safety legislation.

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