Understanding Neurology Medical Billing: Key Coding And Billing Considerations

By Author: Bryan Marcus.
Total Articles: 26
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Neurology is a specialized medical field that involves diagnosing and treating conditions affecting the nervous system. From electromyography (EMG) and nerve conduction studies (NCV) to nerve blocks and other neurological procedures, the services performed by neurology practices can involve detailed coding and billing requirements.

Because of these complexities, Neurology Medical Billing requires billing teams to understand specialty-specific procedures, CPT coding rules, payer requirements, and applicable Medicare policies.

Why Neurology Medical Billing Can Be Complex:

Neurology covers disorders involving the central and peripheral nervous systems, including conditions affecting nerves, muscles, blood vessels, and related tissues. The range of diagnostic and treatment services performed in neurology means that billing teams need to understand the documentation and coding requirements associated with different procedures.

MGSI's neurology billing page specifically highlights EMGs, nerve conduction studies, nerve blocks, and other neurological services as areas that require attention during ...
... the billing process. It also notes the importance of keeping billing departments updated on Medicare regulations and policies related to neurology.

Understanding EMG in Neurology Billing:

Electromyography, commonly known as EMG, is a diagnostic test used to evaluate the electrical activity of muscles and the nerves that control them. During an EMG, electrodes are used to capture electrical signals, which can then be interpreted by a specialist.

EMG may assist in evaluating muscle disorders, nerve damage, and neuromuscular conditions. Because EMG services are closely connected with nerve conduction studies, accurate coding requires attention to the specific services performed and the applicable CPT requirements.

MGSI identifies several commonly used neurology procedure code ranges, including 95816–95819, 95860–95864, 95885–95887, and 95907–95913.

The Role of Nerve Conduction Studies:

Nerve conduction studies evaluate the ability of motor and sensory nerves to transmit electrical impulses. These studies can provide information about the speed and strength of nerve signals and may help identify problems associated with nerve damage or impaired conduction.

For billing purposes, the relationship between NCV and EMG services is particularly important. Neurology billing teams need to understand how these services are documented and which codes apply based on the circumstances of the services performed.

Important CPT Rules for Neurology Billing:

Neurology billing includes specific CPT-level considerations that can affect how claims should be prepared.

According to MGSI's neurology billing guidance, EMG procedure codes 95885–95887 should be billed along with NCV codes rather than as a separate claim. The page also notes that these procedure codes may be billed with multiple units.

Another consideration is whether the NCV and EMG services were performed on the same day or different days. MGSI's page states that when NCV and EMG charges are performed on different days, EMG CPT codes between 95860 and 95864 are used, while services performed on the same day use EMG CPT codes between 95885 and 95887. 

The page also highlights a separate rule involving needle electromyography procedure code 95870, stating that it should not be billed with the listed EMG/NCV codes.

These examples demonstrate why specialty-specific coding knowledge is important when handling Neurology Medical Billing Services.

Staying Current With Medicare and Payer Requirements:

Coding requirements and payer policies can change, so neurology billing teams need processes for staying informed. Medicare regulations and payer-specific policies can affect how procedures are reported and reimbursed.

Regular education and review of coding requirements can help billing teams identify changes and apply appropriate procedures when processing neurology claims.

For a neurology practice, this can be particularly important when billing for diagnostic services such as EMG and NCV, where coding relationships and procedural details can influence claim submission.

Technology and Neurology Billing:

Technology can also play a role in managing a neurology practice's billing workflow. Electronic health records, practice management systems, patient registration tools, scheduling, and billing applications can work together to support administrative processes.

MGSI states that it works with healthcare software firms to support day-to-day billing and EHR needs, as well as front-office functions such as patient queries, appointment scheduling, and patient registration. 

Integrating these functions can help create a more connected workflow between clinical and administrative activities.

Why Specialty-Specific Billing Support Matters:

General medical billing knowledge may not always be enough for specialties with detailed procedural coding requirements. Neurology practices can benefit from billing professionals who understand the relationship between clinical services, documentation, CPT codes, and payer requirements.

MGSI states that it has experience providing Neurology Billing support to small and large neurology groups across multiple U.S. states. The company also states that it has worked in the healthcare industry since 1995 and has supported nearly 600 physicians and healthcare practices across specialties. 

These are MGSI's stated company experience figures and should be considered in that context.

Choosing Neurology Billing Services:

When evaluating Neurology Billing Services, practices can consider several factors:

Experience with neurology-specific procedures

Knowledge of EMG and NCV coding

Understanding of CPT-level billing rules

Familiarity with Medicare and payer requirements

Coding education and compliance processes

EHR and practice management system experience

Claim submission and follow-up processes

Ability to support different practice sizes and locations

A billing team that understands these areas can help practices maintain a more organized approach to their revenue cycle.

Conclusion:

Neurology Medical Billing involves specialized coding and billing considerations that require attention to procedure details, CPT requirements, documentation, and payer policies. EMG and nerve conduction studies are important examples of services where understanding the relationship between procedures and codes is essential.

For neurology practices, maintaining updated billing knowledge and using structured processes can help support accurate claim preparation and revenue cycle management. Specialized Neurology Billing Services can provide additional expertise for practices dealing with the unique requirements of neurological procedures.

MGSI provides neurology billing support and describes its services as covering specialty-specific billing, technology integration, and support for neurology groups across multiple U.S. states.