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Start by differentiating from F-wave studies. You might go to Appendix J of the CPT® manual frequently to review the maximum number of nerve conduction studies you normally report for definite indications. Don't ignore the next column that addresses H-reflex (or Hoffmann's reflex) studies, though, these tests have definite considerations to remember while avoiding denials. Read this neurology billing and coding expert insight and know what neurology CPT codes apply in such a scenario. 1. Know the Difference Between Tests H-reflex as well as F-wave studies both test the patient's late response reflex and assess the complete length of a nerve, but in dissimilar ways. F-waves measure motor nerve fiber function along a nerve and are normally carried out in combination with conventional motor nerve conduction studies. H-reflex studies, though, bore both the sensory as well as motor nerve fibers and test both connections in the spinal cord. Both late response tests can be valuable in assessing nerve conduction in the more proximal portions of the nerve, simply implying that you're studying conduction closer to the spine. These nerve areas are often inaccessible to direct nerve conduction assessment using conventional techniques. Tip: Your physician's report should identify the nerves evaluated with the site of nerve stimulation and muscle recording, and the test characteristics, including latency. Watching notations of the tested nerves in your neurologist's documentation will help you determine when to code for an H-reflex study instead of an F-wave study. 2. Confirm Muscle Tested to Decide Code When you've decided that you're coding for an H-reflex study, Neurology CPT Codes include a couple of self-explanatory codes for the procedure: 95934 -- H-reflex, amplitude as well as latency study; record gastrocnemius/soleus muscle 95936 -- record muscle other than gastrocnemius/soleus muscle. Knowing the muscle your neurologist tests is the key to selecting the correct code. H-reflex studies usually involve evaluation of the gastrocnemius/soleus muscle complex existing in the calf. In unusual instances, H-reflexes require to be tested in muscles except the gastrocnemius/soleus muscle, like in the upper limbs or the intrinsic small muscles of the hand and foot. Result: A lot of your reporting for H-reflex studies will include 95934 as physicians test the gastrocnemius/soleus muscle complex more frequently than other areas. Confirm documentation, though, prior to automatically assigning 95934 for each H-reflex study. 3. Confirm Correct Diagnoses H-reflex studies are very regular for the lower extremities, particularly when the patient goes through radicular pain. The late response studies are frequently used in the evaluation of radiculopathies, plexopathies, polyneuropathies as well as proximal mononeuropathies. In few cases, these studies might be the only abnormal diagnostic test. 4. Look for Modifier Opportunities The codes for H-reflex studies assume unilateral procedures, though don't stop with a single code. Even if the patient has unilateral pathology, the physician roughly always tests both of the extremities. The Medicare Physician Fee Schedule (MPFS) has given codes 95934 and 95936 the bilateral status indicator of '1,' thus you can report bilateral tests when suitable. Want to have more neurology medical billing and coding expert tips and know everything about neurology CPT codes ? Click here to read the entire article and to get access to our monthly Neurology & Pain Management Coding Alert: Your practical adviser for ethically optimizing neurology billing and coding, payment, and efficiency in neurology and pain management practice Read more to perfect your neurology billing and coding and ace neurology CPT codes: http://www.supercoder.com/articles/articles-alerts/nca/payer-update-6-spinal-ablation-guidelines-from-uhc-you-cant-afford-to-miss-107452/
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