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 could lead to a significant loss in reimbursement. Understanding these codes help gain in proper reimbursement.
The Nerve Conduction Studies include following codes:
95900: Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study
95903:Nerve conduction, amplitude and latency/velocity study, each nerve; motor,with F-Wave study
95904:Nerve conduction, amplitude and latency/velocity study, each nerve; Sensory
95905:Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes F-wave study when performed, with interpretation and report
By definition, CPT 95900 is bundled into CPT 95903 when it is performed on the same motor nerve. However, when multiple nerve conduction studies, with or without F Wave study are conducted on different motor nerves during the same session, they are billable using modifier 59 (Distinct Procedural Service) to indicate that a separate, distinct motor nerve was studied. But if multiples sites on the same nerves are stimulated or recorded then these codes are reported just once.
For example: If a physiatrist performs a test on 3 nerves without F-wave and the same 3 nerves are tested with F-wave, only CPT 95903 is reported X number of nerves. However, if the physiatrist performs motor study on 2 nerves in left arm and 2 sensory nerves in the right arm, then both CPT 95900 and CPT 95904 are reportable. If NCS is performed on two different branches of a given motor or sensory nerve, then again appropriate CPT from 95900-95904 series is reported.
There is however a unit limit on the codes. Codes 95900 and 95904 are listed as exclusions to the 3 unit limit and upto 12 units for CPT 95900 and CPT 95904 can be billed and upto 3 units for CPT 95903 can be billed.
For NCS performed with preconfigured electrodes array(s), CPT 95905 should be reported.
Codes 95900-95904 are modifier-51 exempt, so modifier-51(multiple procedure) should not be reported on these codes.
Documentation for Nerve Conduction Studies is very critical. NCS uses sensors to measure and record nerve functions including conduction, amplitude, and latency/velocity. Per AMA (American Medical Association), Nerve Condution studies are only billable if the provider documents the distance between the stimulation and recording sites, conduction velocity, latency values, amplitude and the nerves studied.