EMG CPT CODE CHANGE!
Submitted by Marc R. Nuwer, M.D., Ph.D.
There are major changes in the way that EMG services are to be coded for CPT in 2012. When NCV and EMG are performed together, new EMG codes must be used. The purpose is to remove some duplication in payment that occurred in the traditional coding system.
Starting on January 1, three new codes exist for EMG when done on the same day as NCV testing:
95885 Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited
95886 complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels
(Do not report 95885, 95886 in conjunction with 95860-95864, 95870, 95905)
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 code for primary procedure)
(Do not report 95887 in conjunction with 95867-95870, 95905)
(Use 95885, 95886, 95887 in conjunction with 95900-95904)
As a first example, the physician performs two motor NCV without F tests, two sensory NCV tests, one limb EMG testing six muscles, and another limb EMG testing three muscles. The new correct CPT coding will be:
Motor NCV w/o F 95900 2 units
Sensory NCV 95904 2 units
EMG complete 95886 1 unit
EMG limited 95885 1 unit
As a second example, the physician performed a two limb EMG without performing NCV on the same day. Both limbs included testing 6-7 muscles. Because no NCVs were performed that day on that patient, the old coding is used. The correct coding remains:
EMG 2 limbs 95861
The EMG section has clarified that EMG equipment produces both audible and visual signals. It includes other details regarding the new EMG codes. The new header states:
Needle electromyographic (EMG) procedures include the interpretation of electrical waveforms measured by equipment that produces both visible and audible components of electrical signals recorded from the muscle(s) studied by the needle electrode. Use 95870 or 95885 when four or fewer muscles are tested in an extremity. Use 95860-95864 or 95886 when five or more muscles are tested in an extremity. Use EMG codes (95860-95864 and 95867-95870) when no nerve conduction studies (95900-95904) are performed on that day. Use 95885, 95886 and 95887 for
EMG services when nerve conduction studies (95900-95904) are performed in conjunction with EMG on the same day. Report either 95885 or 95886 once per extremity. Codes 95885 and 95886 can be reported together up to a combined total of four units of service per patient when all four extremities are tested.
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