decisionhealth Newsletters, Coder Pink Sheets - 2011 Issue 1 (January)
MACs working on LCDs for SI and nerve conduction studies
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Article Overview
This article reviews draft Medicare contractor LCD activity that may affect billing and documentation for sacroiliac joint injections and nerve conduction/electromyography services. It is relevant to coders, billers, and clinicians who need to track coverage updates, contractor-specific policy changes, and related guidance for diagnostic and therapeutic procedures. The discussion focuses on policy development status, covered service components, provider limitations, and the general types of documentation and reporting considerations involved.
Why This Topic Matters
Draft LCDs can change which services are covered, who may perform them, and how they must be documented or reported. Understanding these updates helps practices anticipate billing impacts and coverage restrictions before the policies are finalized.
Article Sections
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WPS Medicare - sacroiliac joint injections
This section summarizes a draft local coverage policy under development for sacroiliac joint injection services. It covers the contractor context and the general billing and documentation topics addressed in the accompanying draft materials.
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NGS - nerve conduction studies (NCS)/electromyography (EMG)
This section discusses a separate draft LCD involving nerve conduction and electromyography services. It focuses on contractor policy changes related to provider participation and service oversight.
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Official resources
This section lists source references for the draft LCD materials mentioned in the article. It serves as a pointer to the contractor documents and related CMS pages.
What You Will Learn
- How draft Medicare contractor LCDs may affect sacroiliac joint injection billing
- What broad types of documentation and imaging-related guidance are discussed for SI joint procedures
- How draft policy may affect who can perform nerve conduction and electromyography services
- What contractor-specific coverage concerns are being raised for electrodiagnostic studies
- Where to find the referenced draft LCD source materials
Who Should Read This
- Medical coders
- Medical billers
- Physician office staff
- Pain management practices
- Neurology practices
- Podiatry practices
- Physical therapy providers
- Compliance staff
Codes Discussed
Modifiers Discussed
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