Recent Changes to Nerve Conduction Codes

We have been getting numerous questions on EMG/NCS as to how to count specific nerves or how to code NCS with correct CPT 2013 codes, why our EMG codes are getting denied when billed with NCS codes, etc etc. This is an attempt to demystify all the coding and billing quandaries. AMA made changes to NCS codes as of Jan 1st 2013 and the new codes 95907-95913 replaced the old CPT codes 95900, 95903 and 95904. Per CPT 2013, a single conduction study is defined as a sensory conduction test, a … [Read more...]

How To Correctly Code New EMG Codes ?

In the past few days we received a lot of queries regarding EMG denials and new EMG codes so we decided to write a blog article on this topic.  Hope our readers will find it useful. As of January 1st 2012, AMA has introduced 3 new EMG codes to be used in place of previous EMG codes (95860-95864, 95867-95870) when NCV (Nerve Conduction Velocity) testing and EMG are performed together on the same date of service on the same patient. It is very important to bill the claims correctly if EMG … [Read more...]

4 Best Practices for Collecting Out-of-Pocket Patient Fees

This is a guest post by Brittany Richards from Software Advice. In her post Brittany writes about best practices for collecting out-of-pocket patient fees. One of the most important aspects of a medical practice’s success is collecting the money that a patient owes them. This seems like a “no-brainer,” right? Well that does not necessarily make it an easy feat. Patient out-of-pocket fees account for 30 percent of a practice’s revenue, yet once a patient walks out the door, chances of … [Read more...]

Why CPT 95937 Should Not Be Used For Train of Four (TOF) Monitoring?

CPT 95937 (neuromuscular junction testing (repetitive stimulation, paired stimuli) each nerve, any one method) is used for Neuromuscular Junction Testing and should not be used for Train of Four (TOF) Monitoring. According to CPT guidelines, Neuromuscular Junction Testing is the stimulation of an individual motor nerve by means of repetitive electrical impulses with measurement of the resulting electrical activity of a muscle supplied by that nerve. According to the CPT AssistantApril 2002 … [Read more...]

How To Correctly Code Your EMG Studies To Maximize Your Reimbursement?

Needle EMG is the recording and study of electrical activity of muscles using a needle electrode. Neurologists use EMGs to test the electrical activity of a skeletal muscle to provide a medical diagnosis on a patient. Although these are common procedures but coding them incorrectly can not only cause billing problems but often lead to audits. The Centers for Medicare & Medicaid Services (CMS) outlines clearly its recommendations for EMG billing in the Federal Register (issue of October … [Read more...]

Key to Getting Maximum Reimbursement For Your Intraoperative Neuromonitoring Procedures

The key to getting maximum reimbursement for your IONM procedures is to keep yourself upto date with the payers clinical guidelines. Each individual carrier publishes the policies which outlines the rules and regulations regarding the use of a particular CPT, its limitations of coverage and/or medical necessity of that procedure. It is amazing to see how one payer will pay for neurophysiological services for a spinal surgery due to disc degeneration while others may deny it stating not … [Read more...]

Changes in Intraoperative Neuromonitoring CPT codes and their Effect on Insurance Reimbursements

Have you seen a decline in your Intraoperative Neuromonitoring insurance reimbursements lately? Are you seeing more and more payersdenying your claims stating procedure was not medically necessary or procedure was experimental. Ever thought why - The answer to your question is changes in the medical policies and guidelines. Every Payer has their own clinical policies and they keep revising it from time to time. Recently AMA (American Medical Association) stated, beginning January 1st 2012, … [Read more...]

An Introduction to Mac-based Medical Billing Applications

A piece on medical billing software from Software Advice caught our attention. We wanted to share it with our readers - We thought you might find it useful. Katie Matlack, the medical software writer for Software Advice, noted that with the rise in popularity of iPhones and iPads, many doctors are looking for the same simplicity and convenience in the computer products they use at work. She also made the point that one area in which doctors are always looking to improve is in medical billing. … [Read more...]

How To Correctly Bill Nerve Conduction Studies?

A nerve conduction study (NCS) is a neurological test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. The nerve conduction test provides physicians with information about the functioning of the peripheral nerves including both the type of dysfunction and the likely location of its cause. It is used to help diagnose various diseases that impact the nerves. Coding and billing these procedures incorrectly … [Read more...]

Understanding Burn Codes Just Made Easy

According to the ICD-9 CM official guidelines for coding and reporting, burns are classified by depth, extent and by agent (E code). So before you assign a diagnosis code, here are a few things to remember. Location/anatomic site of the burn Extent/severity of the burn Percentage of the body surface burnt Cause of the burn Severity of the burn is determined by burned surface and the depth of the burn and this comes from the 941-946 series. Burn depths are classified in three … [Read more...]