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36.4.9.15 Nerve Conduction Studies
Nerve conduction studies are indicated whenever a need exists to locate neurologic or muscular symptomatology more precisely in post-traumatic circumstances or general widespread conditions affecting the entire neuromuscular system.
Procedure codes 5-95900, 5-95903, 5-95904, 5-95934, and 5-95936 may be used to submit nerve conduction studies for consideration of reimbursement.
Procedure codes 5-95900, 5-95903, and/or 5-95904 are reimbursed in full for the first nerve study and half for each additional study, regardless of the number of studies. Procedure code 5-95934 and/or 5-95936 are reimbursed in full when performed with procedure codes 5-95900, 5-95903, and/or 5-95904 in addition to the reimbursement for the codes 5-95900, 5-95903, and 5-95904, as outlined previously. If 5-95934 and 5-95936 are billed in multiples, the first is reimbursed in full, and all additional studies are reimbursed at half the fee.
Nerve conduction studies repeated within a three-month period on the same client by the same provider are denied except for the following diagnosis codes:
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