Wiki EMG codes 95910 and 95886

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purnern19

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My provider is trying to bill the codes 95910 and 95886 together for an EMG to Medicare. It is coming back that there is an error with the coding. Does anyone know how to code these correctly?
 
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purnern19 said:
I'm not getting a denial, the claim is not making it past the clearinghouse. The report that comes back from them states there is an error in the coding but doesn't state what the error is.
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I would check with the clearing house to see what the issue is. Coding error is pretty vague and could be a number of things. A couple things that come to mind is charges were not on the same date, units billed may be incorrect, dx is not covered per LCD.
 
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JNeilJil and Purn,
For EMG studies performed with an NCS on the same day, one should bill using CPT codes 95885 (limited study), 95886 (complete study), or 95887 (non-extremity study). These are considered “add-on” codes, and may not be billed independent of an NCS code.Bill together but in differ body muscles areas add modifiers of 50 or LT or Rt
All EMG patients need a physician referral to obtain testing & dd on claim. Also ensure give proper diagnostic code not just Z dx code first and need more than just pain dx.

Reference on billing per Medicare https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=54992

I hope this helps you
Lady T
 
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