Hi Everyone,

I would just like to get the general consensus from anyone working with Doctor’s who perform EMG/Nerve Conduction tests.

Do you normally bill out a New Patient visit (99202/99203) or a Consultation Code (99242/99243)
along with the EMG/Nerve Conduction CPT codes?

I get conflicting information online as to whether this is allowed or not.

But according to CMS LCD guideline I found it stated,
“Usually an E&M service is included in the exam performed just prior to and during nerve conduction studies and / or electromyography.

If the E&M service is a separate and identifiable service, the medical record must document medical necessity and the CPT code must be billed with a Modifier 25″

Do most of you include an E& M code with a 25 mod and then include your EMG/Nerve Conduction codes with it? Does the Doctor perform an actual exam before he begins the test? Wouldn’t that be required if you were going to bill it out this way?

Plus, adding a 25 mod means there’s a separate identifiable issue unrelated to the services (the EMG test) and I can’t imagine the Doctor would be addressing that when the patient’s primary reason for being there is just to get the test done.

Any advice you could give would be greatly appreciated

Thank you!