AAN Urges CMS, Others for Quick Resolution on NCS/EMG Code Processing Issue

January 28, 2013

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The AAN has learned that Centers for Medicare and Medicaid (CMS) Part B Carriers and some private payers are not processing new 2013 Current Procedural Terminology (CPT) codes for nerve conduction studies (NCS) correctly.

It appears that Carriers are recognizing and reimbursing for the new NCS codes (95907-95913), however their systems are not yet set up to recognize the new codes as the appropriate base codes for the EMG add-on procedures (95885-95887). As a result, physicians are appropriately receiving payments for their 2013 NCS services but are inappropriately denied payments for their 2013 EMGs.

The AAN recognizes this as a serious issue that requires immediate attention. The AAN submitted a letter to CMS and sent an email to sixteen (16) CMS Carrier Medical Directors urging that a quick resolution be found. The AAN is also in contact with UnitedHealthcare (UHC) about the same processing error.

In the meantime, members are encouraged to resubmit claims for inappropriately denied EMG payments.