CMS is having a NCS/EMG Code Processing Issue

We heard from one of our clients in California today that the Centers for Medicare and Medicaid (CMS) Part B Carriers and some private players are not processing 2013 CPT codes for NCS correctly.

Carriers are reimbursing for the new NCS codes (95907-95913), but the new systems in place are not setup properly to recognize the new codes. As a result, physicians are appropriately receiving payments for their 2013 NCS services but are inappropriately denied payments for their 2013 EMGs.

CPT=Current Procedural Terminology
NCS=Nerve Conduction Studies

The American Academy of Neurology seems to be on top of the matter and has reached out to the CMS and 16 CMS Directors. They are urging their members to resubmit claims for EMG payments that were wrongly denied. From their release:

We recommend the same thing as well……with physicians consistently getting their fees chipped away at, we feel you have to get everything you possibly can. If you have any question, we urge you to contact the AAN to see if you can

In addition, the AAN has release a FAQ on NCS/EMG Coding.

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