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 studies are performed the same day as nerve conduction studies otherwise the claims will be denied.
Here are the 3 new EMG codes:
- 95885: Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to the code for primary procedure).
- 95886: Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to the code for primary procedure).
- 95887: Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study; (list separately in addition to the code for primary procedure).
Unlike the old EMG codes 95860-95864 where the code specify the number of limbs tested, the new EMG codes state “each extremity”, therefore you may bill up to 4 units for either CPT 95885 or CPT 95886 depending upon the no. of muscles tested. Keep note of the word“limited” in CPT 95885 which means less than five muscles.
(Do not report 95885, 95886 in conjunction with 95860-95864, 95870, 95905 and CPT 95887 in conjunction with 95867-95870, 95905)
Lets take a look at one of the examples: A neurologist performs two limb EMG on five muscles along with a five motor NCV without F test and a two motor sensory NCV test, in that case the correct way to code this is:
CPT 95900 (Motor NCV w/o F test) 5 units
CPT 95904 (Sensory NCV) 2 units
CPT 95886 (EMG complete study) 2 units
Remember the parenthetical language “(list separately in addition to the code for primary procedure)”, this is a reminder that the primary codes ( NCVs) should be reported with these codes. However, if the physician performs only the EMG tests without any Nerve Conduction Studies on the same day then the old EMG codes (95860-95864 and 95867-95870) should be used.
For example: A neurologist performed a one limb EMG (6 muscles) without any NCV on the same day. Because no NCVs were performed that day on that patient, the old Code 95860 ( Needle Electromyography; 1 extremity with or without related paraspinal areas) should be used.
For recent changes in Nerve Conduction Study Codes 2013, please visit our latest blog post
Recent Changes to Nerve Conduction Codes