Motor Nerve Conduction Studies

One of the most frequent coding questions that comes to the office is how to correctly report CPT® codes 95900 and 95903. Code 95900 describes a "Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study. Code 95903 describes a "Nerve conduction study, amplitude and latency/velocity study, each nerve; motor, with F-wave study.

So as you can see, by definition, 95900 is a component of 95903 when performed on the same nerve. They should not both be billed to report study of a single nerve, e.g., median nerve to the abductor pollicis brevis. If you do report both of them, insurance companies will assume that you are trying to unbundle the service and report some of the work twice. This is true if both 95900 and 95903 are billed for studying the median nerve to the APB.

However, many payors follow this rule absolutely, and will bundle any instance of 95900 that is reported with 95903.  This is also not correct. The codes are defined per nerve, and it is appropriate to report a unit of 95900 for one nerve and a unit of 95903 for another. To avoid improper bundling, add modifier 59 to 95900. This indicates the 95900 is distinct from 95903, and should prevent payors from incorrectly bundling together study of two different nerves.

For example, a member emailed me just this week to confirm that it is correct to report 95903 for a motor with F-wave study of the peroneal nerve to the extensor digitorum brevis as well as 95900 for a motor study without F-wave of the peroneal nerve to the tibialis anterior. His analysis is correct, and he would report the first study with 95903 and the second with 95900-59.

Refer to the AANEM List of Nerves for further guidance on what constitutes a nerve. This resource has also been included in the CPT® codebook since 2006 as Appendix J. Each nerve in the list constitutes one unit of service, and can be reported as such.