Short answerEMG and nerve conduction study claims are commonly denied because the number of studies billed doesn't match the report, the diagnosis doesn't meet the payer's medical-necessity policy, needle EMG add-on codes are billed without a nerve conduction code, frequency limits are exceeded, or records requests aren't answered in time.
Electrodiagnostic testing is precise work, and its coding has to be just as precise.
How the codes fit together
| Code | Description |
|---|---|
| 95907–95913 | Nerve conduction studies, by total number of studies (1–2 up to 13 or more) |
| 95885 | Needle EMG, each extremity, limited, with NCS (add-on) |
| 95886 | Needle EMG, each extremity, complete, with NCS (add-on) |
| 95887 | Needle EMG, non-extremity muscles, with NCS (add-on) |
| 95860–95864 | Needle EMG by number of extremities, when no NCS is performed |
Common denial causes
- study count on the claim doesn't match the report
- add-on EMG codes billed alone
- 95860–95864 billed on the same day as NCS (the add-ons apply instead)
- symptom diagnoses that don't meet the payer's policy
- frequency limits for repeat testing
- missed records requests
What the report should include
- the indication for testing
- each nerve studied (motor, sensory, F-wave, H-reflex) so the count is clear
- muscles tested for EMG and whether the study was limited or complete
- interpretation and conclusion
Related: PM&R billing.
This article is general billing information, not legal or coding-compliance advice. Payer rules, CPT descriptors and federal guidance change; check the current versions for your claims.