2025 Coding Guide-7: Frequently Asked Questions

7: Frequently Asked Questions

Pdf Summary

The 2023 AANEM Coding Guide provides a list of frequently asked questions (FAQs) related to coding in various areas of neurology and electromyography. Some key points from the document include:<br /><br />- Coding changes for 2023: A new code specific to neuromuscular ultrasound (NMUS) has been released (CPT code 76883). Guidelines and parenthetical notes have been added for paravertebral spinal nerves and branches codes 64490-64495. An exclusionary parenthetical note has been revised for code 77003. Codes 0766T, 0767T, 0768T, and 0769T have been added for transcutaneous magnetic stimulation. Exclusionary parenthetical notes have been added for EMG and nerve conduction codes.<br />- EMG and NCS codes: No changes have been made to the codes themselves, but exclusionary parenthetical notes regarding the new transcutaneous magnetic stimulation codes have been added.<br />- Medicare payment rates: The 2023 conversion factor for Medicare is $33.89, a decrease from the previous year. Private payers often follow a similar fee-setting process.<br />- Workers compensation and ICD-10: Workers compensation may still be using ICD-9 codes, as they are not required to switch to ICD-10. The use of ICD-10 codes for specific situations, such as a spacecraft collision, may vary depending on state regulations and reporting requirements.<br />- Evaluation and management (E/M) billing: An E/M service may be billed on the same day as a procedure if the E/M was beyond what is included in the procedure code. Modifier 25 is used to indicate this. The use of modifier 26 can be used if only the professional component of a service is performed.<br />- Chemodenervation and modifiers: EMG guidance can be billed separately for chemodenervation, except for larynx procedures. Modifier 59 is still recognized by CMS, but four new HCPCS modifiers (XE, XS, XP, and XU) have been introduced as alternatives for Medicare patients.<br />- Modifier 59 usage: Modifier 59 is commonly monitored by CMS and is misused and abused. It should only be used when documentation supports two separate procedures performed by the same physician on the same day. Other appropriate modifiers should be used when available.<br /> <br />This summary provides a brief overview of the information contained in the document, but it is recommended to review the full guide for more detailed information on each topic.

Keywords

AANEM Coding Guide

neuromuscular ultrasound

CPT code 76883

transcutaneous magnetic stimulation

Medicare payment rates

ICD-10

Evaluation and management billing

Modifier 25

Chemodenervation

Modifier 59