17 Jul How to Bill for Nerve Conduction Studies
Medical practitioners are concerned about helping their patients get well. This drive and ambition is shared among most healthcare professionals and is the ultimate reason they chose to enter a career in the medical field.
The love for helping people, and the willingness to learn more about their area of expertise and beyond, are also what drive people to complete annual continuing education certification programs and attend conferences and lectures hosted by their respected colleagues.
Science, mathematics, and research are typically subjects that come easily to medical professionals. They may need to work harder to develop their social skills or business practices, but they usually do not need much help with making a difficult diagnosis or relating obscure symptoms to a particular disease or ailment.
When it comes to referring patients to a specialist or ordering the proper tests, physicians are typically the masters of their domain. However, when it comes to office management, they may miss the mark.
Medical Billing Issues
Most medical services providers are willing to admit that they have no interest in or desire to learn more about how their billing systems work. They often are completely unaware of what a medical coding chart is or why it is important.
The most recent trend is for the entire office to be cross-trained in several areas, including the billing and coding processes. Despite the usefulness and relevance of this additional training, most medical practitioners would not be comfortable sitting down to process an accurate billing invoice or insurance claim form.
The process of using these formulas and databases is complicated by the knowledge that not every procedure will fit neatly into one of the preprinted boxes. Some patients have unusual conditions or are anomalies that require special treatments which may not always be predictable.
Quite often, insurance companies will balk at these claims because according to their charts a 30 year old patient should not need any special testing for heart abnormalities or to check for blocked arteries. There are several other instances where the unusual tests requested require special billing procedures in order for insurance companies or government agencies to even consider covering the costs.
Nerve Conduction Studies
Sometimes a patient will present with symptoms of numbness, tingling, or burning sensation on a particular part or parts of their body. If a physician has probable cause to suspect there could be some neurological damage, they may request a nerve conduction study. The study is a common neurological test that identifies and evaluates the overall function of peripheral nerves by using stimulating electrodes on the extremities closest to the affected areas. The impulses are conducted and monitored to confirm or disprove the theory that nerve damage exists in the patient and is the cause of their pain or numbness.
Because the testing can be both cumbersome and expensive, insurance companies require a very good reason for the referral and a detailed breakdown of the costs. Medical billers and professional medical billing coders should be familiar with the correct billing codes to use when submitting a claim to the insurance carrier or government agency. The new nerve conduction studies may be billed under the most appropriate code. If one of these is not appropriate, or two separate studies were completed, multiple codes or claims may be required.
- 95900: This code includes nerve conduction, amplitude, and latency/velocity study, and specifies each nerve and motor function, without F-wave study.
- 95903: This code includes nerve conduction, amplitude, and latency/velocity study, and specifies each nerve and motor function, with F-Wave study.
- 95904: This code includes nerve conduction, amplitude, and latency/velocity study, and specifies each nerve and sensory function.
- 95905: This code includes motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude, and latency/velocity study. It specifies each limb and includes F-wave study when performed, with interpretation and report.