decisionhealth Newsletters, Coder Pink Sheets - 2013 Issue 2 (February)
Getting paid: Look out for inappropriate denials of EMG add-on codes with NCS
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Article Overview
This article explains a payment issue affecting electromyography add-on claims when billed with nerve conduction study services. It discusses the denial pattern observed by practices, notes that some Medicare administrative contractors experienced processing delays, and highlights the need for providers and billing teams to monitor explanation-of-benefits activity and payer communications. The piece is relevant to coders, billing staff, and orthopedic or neurology practices handling these services.
Why This Topic Matters
It helps practices recognize that certain denials may reflect payer processing problems rather than claim errors, so they can avoid unnecessary write-offs and follow payer guidance on corrections or adjustments.
What You Will Learn
- The article’s focus on a Medicare-related denial issue affecting electromyography add-on claims.
- Which payer organizations and contractor types were mentioned in connection with the problem.
- Why monitoring EOBs and billing system behavior matters when denials occur.
- How payer updates and carrier communications can affect claim resolution.
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Orthopedic practice managers
- Neurology practice staff
- Compliance or reimbursement specialists
Codes Discussed
Code Ranges Discussed
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