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 motor conduction test w or w/o an f-wave or an H-Reflex test. Each type of study for each nerve includes all orthodromic and antidromic impulses associated with that nerve and hence considered a distinct study. It also states that each type of conduction study is counted only once when multiple sites on the same nerve are stimulated. So if the provider tested radial motor nerve to ECU(extensor carpi ulnaris) and to the EDC (extensor digitoris communis), this would be counted as one study. Hence the total number of tests should be added together to get the right code from 95907-95913. Also remember “only one code would be reported with a maximum of 1 unit of service that represents all the nerve conduction studies performed on that date”.
One such example would be if a physician performs a sensory study and motor study on ulnar nerve, than it would be counted as two studies. Remember the old codes were based on the number of nerves but the new codes are now based on the number of studies, so CPT 95907 would be used.
Another example: where a neurologist performs a median motor and sensory and radial motor and sensory, it would be counted as four studies and CPT 95908 should be reported.
Appendix J in the 2013 CPT book provides the maximum number of studies that can be performed for a particular indication.
Another frequently asked question is “are NCS codes primary codes to EMG codes (95885-95887) and the answer to this question is “Yes”. The EMG codes are add-on codes and by definition, they must be reported with the primary base codes which are NCS codes. If the physician is performing EMG and NCS during the same encounter then CPT 95885-95887 should be billed with the new NCS codes 95907-95913. But if only EMG studies are being performed without NCS then the old codes 95860, 95861-95863, 95864-95870) should be used.