ED Coding & Reimbursement Alert - 2010 Issue 26
Reader Question: Counting Nerve Conduction Test Per Limb Will Result in Denials
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Article Overview
This premium article explains a reader question about denials involving diagnostic electrodiagnostic services. It focuses on how nerve conduction studies, EMG-related testing, H-reflex reporting, bilateral reporting considerations, and Medicare contractor coverage policies can affect claim submission. The material is intended for coding professionals, billers, and practice staff who work with neurology, PM&R, or other specialties that perform electrodiagnostic testing.
Why This Topic Matters
Electrodiagnostic claims can be denied when services are reported in a way that does not match payer expectations. Understanding the article helps readers recognize the kinds of billing and documentation issues that may affect reimbursement for these tests.
What You Will Learn
- How electrodiagnostic testing claims may be reported and why denials can occur
- The general relationship between nerve conduction testing, EMG, and H-reflex services
- How payer and Medicare coverage guidance can influence reporting practices
- Why bilateral reporting and units of service may matter in this type of claim
Who Should Read This
- Medical coders
- Billing staff
- Compliance staff
- Neurology practices
- Physical medicine and rehabilitation practices
- Electrodiagnostic testing providers
Codes Discussed
Modifiers Discussed
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