Advancing Neuromuscular, Musculoskeletal, & Electrodiagnostic Medicine

AANEM's News Stories

CPT Codes Changes to be Effective January 1

11/14/2011
 
As reported in the May 2011 AANEM News (p. 17, 18), since early 2010 the AANEM has been working with the CPT Editorial Panel on EMG and NCS codes since early 2010.  The CPT Panel had argued that a duplication of effort existed when both EMG and NCS were billed and insisted that the AANEM, AAN, and AAPMR propose new codes to address this situation.
 
The Editorial Panel required the groups to create a new set of codes for 2012 as an interim step to a future code set   that will further bundle EMG and NCS codes beginning in 2013.  The AANEM was under a confidentiality agreement until recently about the 2012 change and is still under a confidentiality agreement regarding the 2013 changes.  The new interim codes were briefly presented in the November 2011 AANEM News (p 14).
 
It is important that you update your billing forms/systems before year end to ensure claims sent after January 1, 2012, are billed correctly.  Claims not billed correctly will be denied. EMG studies performed the same day as nerve conduction studies must now be reported by these new codes:
 
95885: Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to the code for primary procedure).
95886: Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to the code for primary procedure).
95887: Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study; (list separately in addition to the code for primary procedure). 
 
Limited EMGs are those that test less than five muscles.
 
The parenthetical language stating "(list separately in addition to the code for primary procedure)" is a prompt to remind physicians to also report a nerve conduction code with these EMG codes. 
 
Depending on the number of extremities tested and the type of testing performed, you may bill up to a quantity of 4 for either 95885 or 95886. Remember:
 
* Use these codes in conjunction with NCS codes 95900-95904.
* Do not report these codes with 95905.
* Do not report these codes in conjunction with existing EMG codes 95860-95864, 95867-95870.
 
If you do not perform NCS the same day as EMG, you may report the existing EMG codes 95860-95864, 95867-95870.
 
The AANEM believes that these changes will not negatively impact your practice based on the new work values assigned to these codes. Please contact policy@aanem.org with questions