EMG Billing Question

[runfastnow]

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Question about NCS billing and counting nerves.

My typical upper extremity NCS study:
Sensory + Motor Median | Sensory + Motor Ulnar | Sensory Radial = 5-6 nerves billing

I've started doing some more median/ulnar and median/radial comparison studies - do you/would you guys count that as a separate nerve study or do they fall under the sensory studies of median/ulnar/radial and still stay in the 5-6 nerve billing category? I've seen conflicting answers (and most are 4+ years old) on various billing chats.

Thanks.

 

[JBM16BYU]

I was always taught that a comparison study (median/ulnar or median/radial) was separate because it is different than the typical median (M+S), ulnar (M+S), and radial (S) studies.

 

[maddymadz]

Question about NCS billing and counting nerves.

My typical upper extremity NCS study:
Sensory + Motor Median | Sensory + Motor Ulnar | Sensory Radial = 5-6 nerves billing

I've started doing some more median/ulnar and median/radial comparison studies - do you/would you guys count that as a separate nerve study or do they fall under the sensory studies of median/ulnar/radial and still stay in the 5-6 nerve billing category? I've seen conflicting answers (and most are 4+ years old) on various billing chats.

Thanks.

Any specific nerve can be billed just once
even if comparison studies are made.The sensory and motor responses are of course separate .

 

[maddymadz]

Question about NCS billing and counting nerves.

My typical upper extremity NCS study:
Sensory + Motor Median | Sensory + Motor Ulnar | Sensory Radial = 5-6 nerves billing

I've started doing some more median/ulnar and median/radial comparison studies - do you/would you guys count that as a separate nerve study or do they fall under the sensory studies of median/ulnar/radial and still stay in the 5-6 nerve billing category? I've seen conflicting answers (and most are 4+ years old) on various billing chats.

Thanks.

Any specific nerve can be billed just once
even if comparison studies are made.The sensory and motor responses are of course separate .

 

[JBM16BYU]

I guess it depends on what OP means as a comparison study. For example, if you perform median motor, median antidromic sensory, ulnar motor, ulnar antidromic sensory, but then do median/ulnar palmar mixed study (technically a comparison study), that study is billed as an additional NCS, so it would be 5 NCS total. To clarify, @maddymadz , are you saying that a 4th digit study (median / ulnar) or a 1st digit study (median / radial) or even a palmar mixed study would not be billed as a separate study, so in the original example you would still only bill 4? Interested in your thoughts. Thanks.

 

[runfastnow]

I guess it depends on what OP means as a comparison study. For example, if you perform median motor, median antidromic sensory, ulnar motor, ulnar antidromic sensory, but then do median/ulnar palmar mixed study (technically a comparison study), that study is billed as an additional NCS, so it would be 5 NCS total. To clarify, @maddymadz , are you saying that a 4th digit study (median / ulnar) or a 1st digit study (median / radial) or even a palmar mixed study would not be billed as a separate study, so in the original example you would still only bill 4? Interested in your thoughts. Thanks.

Old thread - but yes this is what I was getting at.

Sensory M+U+R + Motor M+U + 4th digit M/U comparison. I've been treating this as six studies (even though falls under the 5-6 study code). It does make a difference though if I do more studies on another limb.

 

[maddymadz]

I guess it depends on what OP means as a comparison study. For example, if you perform median motor, median antidromic sensory, ulnar motor, ulnar antidromic sensory, but then do median/ulnar palmar mixed study (technically a comparison study), that study is billed as an additional NCS, so it would be 5 NCS total. To clarify, @maddymadz , are you saying that a 4th digit study (median / ulnar) or a 1st digit study (median / radial) or even a palmar mixed study would not be billed as a separate study, so in the original example you would still only bill 4? Interested in your thoughts. Thanks.

That’s what I have been told to bill .A sensory study for a specific nerve can be billed only once ,whether antidromic/ orthodromic/comparison studies.In the first instance,it would be 4NCS.Same principle hold’s good for a motor nerve ,anyway there is always one type in that.That’s my understanding.If were to do an antidromic median and do a mixed palmar study only,it would be considered as 2NCS,as the ulnar snap is represented in the comparison study.