E/M Coding Alert - 2007 Issue 5
NEUROLOGY: Don't Bill Nerve Conduction Studies Unless You Can Document Necessity
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Article Overview
This article explains payer attention to nerve conduction study billing and reviews concerns about office-based testing devices, provider qualifications, documentation of medical necessity, and specialty-related coverage issues. It is aimed at clinicians, coders, and billing staff who need to understand the general compliance and documentation topics affecting electrodiagnostic testing.
Why This Topic Matters
It helps readers assess whether their nerve conduction study billing, documentation, and provider setup align with payer expectations and specialty guidance, especially when testing is performed in the office setting.
Article Sections
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Carrier will monitor NCS billings for problems
Introduces payer scrutiny of nerve conduction study billing and the broader concern about increased claims activity.
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Office-based testing equipment concerns
Discusses concerns about newer in-office devices, their general capabilities, and how payers are viewing them.
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Specialty training and supporting testing resources
Summarizes professional society guidance on physician training and the relationship between nerve conduction studies and other electrodiagnostic testing resources.
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Clinical and documentation pitfalls
Covers general risks related to limited testing approaches, specialty classification, and the need for documentation supporting medical necessity.
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Carrier and professional society resources
Points readers to payer and professional organization materials referenced in the article.
What You Will Learn
- How payer scrutiny may affect nerve conduction study billing
- Why office-based testing devices are drawing attention
- What types of provider qualifications and testing resources are discussed
- How documentation and medical necessity concerns relate to electrodiagnostic testing
- Which payer and professional society resources are referenced
Who Should Read This
- Physicians
- Neurologists
- Primary care practices
- Medical coders
- Billing staff
- Practice managers
Codes Discussed
Code Ranges Discussed
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