What does CPT code 95886 mean?

Needle electromyography
CPT code 95886 is described as “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 …

Does CPT 95886 need a modifier?

Yes – Double check which CPT code is being flagged as needing a modifier. When 95885 and 95886 are billed together, some payers will want the modifier -59 attached to 95885. Some payers may also want to see modifier -59 on nerve conduction code 95900 if it is billed with 95903.

How do you bill an EMG?

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).

Can 95910 be billed alone?

Each descriptor (code) from codes 95907, 95908, 95909, 95910, 95911, 95912, and 95913, can be reimbursed only once per nerve, or named branch of a nerve, regardless of the number of sites tested or the number of methods used on that nerve. Motor and sensory nerve testing are considered separate tests.

Does Medicare cover EMG tests?

Medicare does not have a National Coverage Determination for electromyography (EMG) and nerve conduction studies.

How do you count nerve conduction studies?

Each type of nerve conduction study is counted only once when multiple sites on the same nerve are stimulated or recorded. The number of these separate tests should be added to determine which code to use. For a list of nerves, refer to the List of Nerves in CPT Appendix J.

What is EMG in billing?

Needle EMG is the recording and study of electrical activity of muscles using a needle electrode. The Centers for Medicare & Medicaid Services (CMS) outlines clearly its recommendations for EMG billing in the Federal Register (issue of October 31, 1997, Vol.

What are EMG codes?

Electromyography Overview Needle EMG (CPT codes 95860-95870) is performed to exclude, diagnose, describe, and follow diseases of the peripheral nervous system and muscle. Needle EMG refers to the recording and study of electrical activity of muscle using a needle electrode.

What’s the difference between CPT 95885 and 95886?

These codes are more optimally worded. As you can see, CPT 95885 is reported for a limited EMG during a nerve conduction study while CPT 95886 is reported for a complete EMG during a nerve conduction study.

How to bill for two units of 95886?

When billing for two or more units of 95886, code as two line items appending modifier 59 to the second. My claims coded in this manner were paid. I think it all depends on the Carrier. I do get paid by Aetna and UHC using units.

Is the EMG code 95886 x 2 accurate?

Everything that I have read, including numerous documents published by the American Academy of Neurology, indicate 95886 x 2 (or the appropriate number of extremities) as one line item is accurate. My carrier (Cahaba GBA – Tennessee) is denying this code when billed for more than one extremity.

Can you deny multiple extremities of 95886?

I am having denial difficulties when billing for multiple units (multiple extremities) of 95886. Everything that I have read, including numerous documents published by the American Academy of Neurology, indicate 95886 x 2 (or the appropriate number of extremities) as one line item is accurate.