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Start by marking a difference from F-wave studies. You might flip Appendix J of the CPT® manual most frequently to review the most 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, as these tests have definite considerations to keep in mind while side-stepping denials. Read this neurology billing and coding expert insight on what neurology CPT codes you should use to ensure flawless split night claims. 1. Study Difference Between Tests H-reflex along with F-wave studies both test the patient's late response reflex and evaluate the whole length of a nerve, but in dissimilar ways. F-waves evaluate motor nerve fiber function along a nerve and are typically conducted grouped with conventional motor nerve conduction studies. H-reflex studies, though, include both the sensory as well as motor nerve fibers as well as test both connections in the spinal cord. Tip: Your physician's report should classify the nerves assessed with the site of nerve stimulation as well as muscle recording, along with the test characteristics, involving latency. Looking at notations of the tested nerves in your neurologist's documentation will help you decide when you should code for an H-reflex study in place of an F-wave study. 2. Verify Muscle Tested to Determine Code Once you've decided that you're coding for an H-reflex study, CPT® covers two self-explanatory neurology CPT codes meant for the procedure: 95934 -- H-reflex, amplitude and latency study; record gastrocnemius/soleus muscle 95936 -- Record muscle other than gastrocnemius/soleus muscle. If you know that the muscle your neurologist tests is the significant to selecting accurate neurology CPT codes. H-reflex studies generally include assessment of the gastrocnemius/soleus muscle complex in the calf. In rare occurrences, H-reflexes require to be tested in muscles except the gastrocnemius/soleus muscle, for instance in the upper limbs or the intrinsic small muscles located in the hand and foot." Result: A lot of of your reporting for H-reflex studies will involve 95934 as physicians test the gastrocnemius/soleus muscle complex more regularly than rest of the areas. Validate documentation, though, prior to automatically allocating 95934 for every H-reflex study. 3. Correct Diagnoses H-reflex studies are very general for the lower extremities, predominantly when the patient goes through radicular pain. The late response studies are regularly used in the evaluation of radiculopathies, plexopathies, polyneuropathies as well as proximal mononeuropathies. In few cases, these studies might be the lone abnormal diagnostic test. 4. Look Out for Modifier Opportunities The neurology CPT codes for H-reflex studies undertake unilateral procedures, however don't stop with a single code. H-reflex studies are generally carried out bilaterally as symmetry of responses is an essential standard for abnormality. Bilateral studies are specified when an abnormal response is seen in a unilaterally symptomatic limb or when there is a problem that the response may possibly be abnormal for causes except pathology, for instance advanced age. Want to have more neurology 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 coding, payment, and efficiency in neurology and pain management practice Read more to perfect your neurology billing and coding: http://www.supercoder.com/articles/articles-alerts/nca/neurology-keep-4-points-in-mind-for-successful-h-reflex-test-coding-107780/
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