Tuesday, June 14, 2011

Which Nerve Conduction Study Code Is Right for you?

Selecting the proper code to describe your nerve conduction test can prove to be a demanding proposition; but that need not be the case if you learn three important areas:

Here are some steps to boost your medical coding and billing know how and to make the proper choice every time.

Physicians make use of nerve conduction studies (NCS) to assess the function and electrical conduction of motor and sensory nerves in the body. CPT provides you with three options when you face nerve conduction studies coding: 95900, 95903, and 95904.

First step: Review carefully the physician's documentation for the individual nerves stimulated. Bear in mind that you can report only one unit of service of the corresponding NCS code when the neurologist carries out a diagnostic study on the same nerve at multiple sites.

Use codes 95900, 95903, and 95904 by "each nerve and ensure you follow this guide and are not reporting multiple units of service for NCS testing at multiple sites on the same nerve as "separate nerves".

Go for 95900, 95903 and/or 95904 only once when the provider stimulates or records multiple sites on the same nerve. Code 95903 includes both the F-wave study and the underlying motor nerve conduction study. As per NCCI edits, you cannot bill both 95900 and 95903 for motor NCS testing on the same nerve. CCI takes the Column 2 code, 95900 as a component of the more comprehensive Column 1 code 95903.

You should know when to add modifiers

While coding nerve conduction studies, modifiers can certainly come in handy especially when the doctor tests different nerves or nerve braches or carries out different diagnostic NCS.

Here's an example: The physician carries out a motor NCS without F-wave on the right motor ulnar nerve to the abductor digit minimi (ADM) muscles. During the same procedure, he also carries out a motor nerve conduction study with F-wave on the right radial motor nerve to the extensor digitorum communis (EDC) muscle.

You should report 95900 for the first motor NCS and 95903 for the second owing to the fact that the doctor carried out the diagnostic studies on different nerves. Add modifier 59 to the 95900 code to indicate that the physician performed a separate motor NCS on a different nerve.

You should establish medical necessity

The patient's signs and/or symptoms or a confirmed diagnosis support medical necessity while ordering a diagnostic procedure. The doctor must document the information in the order and note for the procedure. Information aiding medical necessity should also be in the professional interpretation report for the diagnostic study.

Caution: NCS studies look for underlying conditions or injuries that could cause compromised nerve function. Owing to this, numbness, tingling, weakness, and loss of sensation are all symptoms that can help support medical necessity for the diagnostic study, particularly when the final interpretation points to normal NCS.

For further details on this and for other medical coding and billing updates, sign up for a one-stop medical coding guide like Supercoder.

For More Info :- http://www.supercoder.com/coding-newsletters/my-neurology-coding-alert/know-which-nerve-conduction-study-code-is-right-for-you-article

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