This is what you can expect from NDS as far as Billing Procedures:
The EMG/NCV billing and reimbursement for our neurodiagnostic services are simplified: your practice bills everything and keeps everything; your office is charged a flat fee per study performed (either upper/lower profile of one or more extremities).
Your results will be emailed to your office once the report with the interpretation has been written. This usually takes 1-3 business days.
To schedule a test with our office, there is no minimum number of patients that your office needs to provide (in most instances). We will travel within Chicago and the Chicagoland area for testing, as well as the New York City area.
The CPT codes below are the codes which are commonly billed out depending on the EMG/NCV performed. All insurances will reimburse at different levels, so you may need to check with the carrier if you have specific questions regarding this.
New Codes for EMG:
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).
Codes for EMG (these codes have been replaced, but may still be used by insurance companies)
95860 Needle electromyography, one extremity with or without related paraspinal areas.
95861 Needle electromyography, two extremities with or without related paraspinal areas.
95863 Needle electromyography, three extremities with or without related paraspinal areas.
95864 Needle electromyography, four extremities with or without related paraspinal areas
New Codes for NCV:
CPT codes 95900, 95903, 95934 and 95904 will be deleted as of January 1, 2013, no longer will you need to differentiate between the type of nerve conduction studies performed. You only need to count the number of studies and choose the corresponding code. For the purposes of coding, a nerve conduction test is defined as a sensory conduction test, a motor conduction test with or without F-Wave, and an H-Reflex test.
The new codes for Nerve Conduction Studies are as follows:
- 95907 1-2 Nerve conduction studies
- 95908 3-4 Nerve conduction studies
- 95909 5-6 Nerve conduction studies
- 95910 7-8 Nerve conduction studies
- 95911 9-10 Nerve conduction studies
- 95912 11-12 Nerve conduction studies
- 95913 13 or more Nerve conduction studies
Codes For NCV which have been replaced:
95900 Nerve conduction motor, without F-wave study.
95903 Nerve conduction with F-wave study.
95904 Nerve conduction sensory.
95934 H-reflex gastrocnemius/soleus muscle.
To give you an idea of reimbursement, here is a link to how Medicare reimburses the tests: Medicare reimbursement sample