What is a 59 modifier?

The definition of the 59 modifier per the CPT manual is as follows: Modifier 59: “Distinct Procedural Service” – Under certain circumstances, the physician may need to indicate that a procedure or service was distinct or independent from other services performed on the same day.

Is EMG test covered by Medicare?

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

How do you bill a nerve conduction study?

CPT code 95869 should be used to bill a limited EMG study of specific muscles. Examinations confined to distal muscles only, such as intrinsic foot or hand muscles, will be reimbursed as Code 95869 and not as 95860-95866. Use CPT Code 95869 to study thoracic paraspinal muscles between T3 and T11.

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). These are considered “add-on” codes, and may not be billed independent of an NCS code.

Does Medicare pay for nerve conduction studies?

Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT) – is not covered by Medicare.

Can nurse practitioners do Emgs?

Electromyography (EMG) should typically be performed with NCS. Furthermore, EMG and NCS are part of the core residency training for neurologists and physiatrists but not for other health care professionals (physicians, podiatrists, physical therapists, nurse practitioners, and physician assistants).

Does 95886 need a modifier?

Guest. 95886 is an add-on code so it shouldn’t need a modifier, but several places online say some carriers want you to use a 59.

What is CPT code for EMG?

CPT Code 95860, Needle EMG should be used for the study of one extremity. CPT Code 95861, Needle EMG should be used for the study of two extremities.

What is EMG in medical billing?

Needle EMG is the recording and study of electrical activity of muscles using a needle electrode. Neurologists use EMGs to test the electrical activity of a skeletal muscle to provide a medical diagnosis on a patient.