Recovery Audit Contractors: RAC Sets Sights on Auditing Nerve Conduction Study Code 95904

Why This Topic Matters

It helps readers recognize why certain nerve conduction study claims may draw audit attention and what general claim areas are being reviewed. It also highlights the need to keep electrodiagnostic coding and documentation aligned with current CPT guidance and payer expectations.

Article Sections

1. Audit focus and claim review concern

   Introduces the recovery audit contractor issue and the general claim pattern under review. It frames why nerve conduction study claims may warrant closer internal review.

2. FAQs on nerve conduction study billing

   Presents three common billing questions related to nerve conduction studies and related electrodiagnostic services. The discussion addresses unit counting, diagnosis documentation, and when additional coding elements may not be needed.

3. Question 1: Know when multiple units are justified

   Discusses how nerve conduction study units are assessed when multiple nerves or sides are tested. It focuses on the general relationship between testing structure and claim reporting.

4. Question 2: Make sure diagnosis code is specific and accurate

   Reviews the importance of linking the service to appropriate supporting documentation and a specific diagnosis. It also notes payer review and patient notice considerations at a general level.

5. Question 3: Know when modifiers are unnecessary

   Explains a coding update affecting combined electrodiagnostic services and discusses the general need to use the current CPT structure. It addresses documentation-based reporting rather than modifier-based corrections.