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Blue Cross & Blue Shield of Mississippi has updated the Medical Policy for Automated Point-of-Care Nerve Conduction Tests. The update specifically related to nerve conduction studies performed without a needle electromyography will become effective for dates of service on or after December 1, 2010.
The Medical Policy for Automated Point-of-Care Nerve Conduction Tests has been updated to clarify proper coding and medical necessity requirements. The update specifically related to nerve conduction studies performed without a needle electromyography will become effective for dates of service on or after December 1, 2010. As such, it is important that you review the updates and share this information with your staff prior to December 1, 2010.
Please review the revised policy carefully to ensure you and your clinic staff are informed on the policy changes. Certain highlights include:
- Clarification on the appropriate use of CPT or HCPCS codes. You should ensure that the appropriate code is billed for the service rendered. CPT Codes 95900, 90903 and 90904 should not be used to bill for automated point-of-care nerve conduction testing.
- Any automated device, specifically listed or not, was considered and remains investigational. The list included in the current policy has been updated to reflect additional vendors. The list included in the policy, however, is not all inclusive. Any devices equivalent to the ones listed would also be considered investigational. When submitting a claim for an automated point-of-care nerve conduction test, code S3905 should always be used.
- Revised language to state that nerve conduction studies performed without a needle electromyography (EMG) are considered investigational and are not medically necessary.
Please revise your office procedures as necessary to ensure services rendered meet the updated medical policy requirements.
As part of your clinic’s procedures, you should always check medical policy to ensure services rendered meet medical necessity requirements. You can verify the medical necessity of services by reviewing medical policy for the Blue Cross Blue Shield Plan that covers your patient. You may access the links to medical policy under the “Medical Policy” section on the left side of the i’m a provider page.
We look forward to a continued partnership with your clinic as we work together to achieve a Healthier Mississippi! If you have questions, please call our Provider Call Center at 601-932-1122 or 1-800-257-5825.