Palm stim coding

[spondy14]

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I often check an ortho palm comparison median/ulnar if the anti median is prolonged or abnormal...and never quite sure how to code this. Do you code for two more sensory, one sensory, or no code since you have already checked both the median and ulnar anti's??

 

[PMR 4 MSK]

orthos are coded seperately from antis - different stim and pick-up points = seperate nerves. AANEM puts out a good coding guide - I think you can get it from their website - might have to pay for it.

If I do median and ulnar anti- and ortho-dromic studies, that's 4 units of sensory NCS. Most insurance companies, including Medicare pay for this. There are a few insurance companies that will fight it, and you might want to make a comment in the discussion as to why you chose to do them in case it gets audited.