Notification



Notification Issue Date:



Policy Attachment

Attachment to Policy # MA07.033f


Attachment:G

Policy #:MA07.033f

Description:ICD-10 codes

Title:Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies


Inclusion of a code in this table does not imply reimbursement. Eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.

The codes listed below are updated on a regular basis, in accordance with nationally accepted coding guidelines. Therefore, this policy applies to any and all future applicable coding changes, revisions, or updates.

In order to ensure optimal reimbursement, all health care services, devices, and pharmaceuticals should be reported using the billing codes and modifiers that most accurately represent the services rendered, unless otherwise directed by the Company.

The Coding Table lists any CPT, ICD-9, ICD-10, and HCPCS billing codes related only to the specific policy in which they appear.


THE FOLLOWING CODES REPRESENT INDICATIONS THAT SUPPORT MEDICAL NECESSITY
ICD-10 Code Narrative
S12.001DUnspecified nondisplaced fracture of first cervical vertebra, subsequent encounter for fracture with routine healing
S12.001GUnspecified nondisplaced fracture of first cervical vertebra, subsequent encounter for fracture with delayed healing
S12.001KUnspecified nondisplaced fracture of first cervical vertebra, subsequent encounter for fracture with nonunion
S12.001SUnspecified nondisplaced fracture of first cervical vertebra, sequela
S12.100AUnspecified displaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.100BUnspecified displaced fracture of second cervical vertebra, initial encounter for open fracture
S12.100DUnspecified displaced fracture of second cervical vertebra, subsequent encounter for fracture with routine healing
S12.100GUnspecified displaced fracture of second cervical vertebra, subsequent encounter for fracture with delayed healing
S12.100KUnspecified displaced fracture of second cervical vertebra, subsequent encounter for fracture with nonunion
S12.100SUnspecified displaced fracture of second cervical vertebra, sequela
S12.101AUnspecified nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.101BUnspecified nondisplaced fracture of second cervical vertebra, initial encounter for open fracture
S12.101DUnspecified nondisplaced fracture of second cervical vertebra, subsequent encounter for fracture with routine healing
S12.101GUnspecified nondisplaced fracture of second cervical vertebra, subsequent encounter for fracture with delayed healing
S12.101KUnspecified nondisplaced fracture of second cervical vertebra, subsequent encounter for fracture with nonunion
S12.101SUnspecified nondisplaced fracture of second cervical vertebra, sequela
S12.200AUnspecified displaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.200BUnspecified displaced fracture of third cervical vertebra, initial encounter for open fracture
S12.200DUnspecified displaced fracture of third cervical vertebra, subsequent encounter for fracture with routine healing
S12.200GUnspecified displaced fracture of third cervical vertebra, subsequent encounter for fracture with delayed healing
S12.200KUnspecified displaced fracture of third cervical vertebra, subsequent encounter for fracture with nonunion
S12.200SUnspecified displaced fracture of third cervical vertebra, sequela
S12.201AUnspecified nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.201BUnspecified nondisplaced fracture of third cervical vertebra, initial encounter for open fracture
S12.201DUnspecified nondisplaced fracture of third cervical vertebra, subsequent encounter for fracture with routine healing
S12.201GUnspecified nondisplaced fracture of third cervical vertebra, subsequent encounter for fracture with delayed healing
S12.201KUnspecified nondisplaced fracture of third cervical vertebra, subsequent encounter for fracture with nonunion
S12.201SUnspecified nondisplaced fracture of third cervical vertebra, sequela
S12.300AUnspecified displaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.300BUnspecified displaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.300DUnspecified displaced fracture of fourth cervical vertebra, subsequent encounter for fracture with routine healing
S12.300GUnspecified displaced fracture of fourth cervical vertebra, subsequent encounter for fracture with delayed healing
S12.300KUnspecified displaced fracture of fourth cervical vertebra, subsequent encounter for fracture with nonunion
S12.300SUnspecified displaced fracture of fourth cervical vertebra, sequela
S12.301AUnspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.301BUnspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.301DUnspecified nondisplaced fracture of fourth cervical vertebra, subsequent encounter for fracture with routine healing
S12.301GUnspecified nondisplaced fracture of fourth cervical vertebra, subsequent encounter for fracture with delayed healing
S12.301KUnspecified nondisplaced fracture of fourth cervical vertebra, subsequent encounter for fracture with nonunion
S12.301SUnspecified nondisplaced fracture of fourth cervical vertebra, sequela
S12.400AUnspecified displaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.400BUnspecified displaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.400DUnspecified displaced fracture of fifth cervical vertebra, subsequent encounter for fracture with routine healing
S12.400GUnspecified displaced fracture of fifth cervical vertebra, subsequent encounter for fracture with delayed healing
S12.400KUnspecified displaced fracture of fifth cervical vertebra, subsequent encounter for fracture with nonunion
S12.400SUnspecified displaced fracture of fifth cervical vertebra, sequela
S12.401AUnspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.401BUnspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.401DUnspecified nondisplaced fracture of fifth cervical vertebra, subsequent encounter for fracture with routine healing
S12.401GUnspecified nondisplaced fracture of fifth cervical vertebra, subsequent encounter for fracture with delayed healing
S12.401KUnspecified nondisplaced fracture of fifth cervical vertebra, subsequent encounter for fracture with nonunion
S12.401SUnspecified nondisplaced fracture of fifth cervical vertebra, sequela
S12.500AUnspecified displaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.500BUnspecified displaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.500DUnspecified displaced fracture of sixth cervical vertebra, subsequent encounter for fracture with routine healing
S12.500GUnspecified displaced fracture of sixth cervical vertebra, subsequent encounter for fracture with delayed healing
S12.500KUnspecified displaced fracture of sixth cervical vertebra, subsequent encounter for fracture with nonunion
S12.500SUnspecified displaced fracture of sixth cervical vertebra, sequela
S12.501AUnspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.501BUnspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.501DUnspecified nondisplaced fracture of sixth cervical vertebra, subsequent encounter for fracture with routine healing
S12.501GUnspecified nondisplaced fracture of sixth cervical vertebra, subsequent encounter for fracture with delayed healing
S12.501KUnspecified nondisplaced fracture of sixth cervical vertebra, subsequent encounter for fracture with nonunion
S12.501SUnspecified nondisplaced fracture of sixth cervical vertebra, sequela
S12.600AUnspecified displaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.600BUnspecified displaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.600DUnspecified displaced fracture of seventh cervical vertebra, subsequent encounter for fracture with routine healing
S12.600GUnspecified displaced fracture of seventh cervical vertebra, subsequent encounter for fracture with delayed healing
S12.600KUnspecified displaced fracture of seventh cervical vertebra, subsequent encounter for fracture with nonunion
S12.600SUnspecified displaced fracture of seventh cervical vertebra, sequela
S12.601AUnspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.601BUnspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.601DUnspecified nondisplaced fracture of seventh cervical vertebra, subsequent encounter for fracture with routine healing
S12.601GUnspecified nondisplaced fracture of seventh cervical vertebra, subsequent encounter for fracture with delayed healing
S12.601KUnspecified nondisplaced fracture of seventh cervical vertebra, subsequent encounter for fracture with nonunion
S12.601SUnspecified nondisplaced fracture of seventh cervical vertebra, sequela
S12.9XXAFracture of neck, unspecified, initial encounter
S12.9XXDFracture of neck, unspecified, subsequent encounter
S12.9XXSFracture of neck, unspecified, sequela
S14.0XXAConcussion and edema of cervical spinal cord, initial encounter
S14.0XXDConcussion and edema of cervical spinal cord, subsequent encounter
S14.0XXSConcussion and edema of cervical spinal cord, sequela
S14.101AUnspecified injury at c1 level of cervical spinal cord, initial encounter
S14.101DUnspecified injury at c1 level of cervical spinal cord, subsequent encounter
S14.101SUnspecified injury at c1 level of cervical spinal cord, sequela
S14.102AUnspecified injury at c2 level of cervical spinal cord, initial encounter
S14.102DUnspecified injury at c2 level of cervical spinal cord, subsequent encounter
S14.102SUnspecified injury at c2 level of cervical spinal cord, sequela
S14.103AUnspecified injury at c3 level of cervical spinal cord, initial encounter
S14.103DUnspecified injury at c3 level of cervical spinal cord, subsequent encounter
S14.103SUnspecified injury at c3 level of cervical spinal cord, sequela
S14.104AUnspecified injury at c4 level of cervical spinal cord, initial encounter
S14.104DUnspecified injury at c4 level of cervical spinal cord, subsequent encounter
S14.104SUnspecified injury at c4 level of cervical spinal cord, sequela
S14.105AUnspecified injury at c5 level of cervical spinal cord, initial encounter
S14.105DUnspecified injury at c5 level of cervical spinal cord, subsequent encounter
S14.105SUnspecified injury at c5 level of cervical spinal cord, sequela
S14.106AUnspecified injury at c6 level of cervical spinal cord, initial encounter
S14.106DUnspecified injury at c6 level of cervical spinal cord, subsequent encounter
S14.106SUnspecified injury at c6 level of cervical spinal cord, sequela
S14.107AUnspecified injury at c7 level of cervical spinal cord, initial encounter
S14.107DUnspecified injury at c7 level of cervical spinal cord, subsequent encounter
S14.107SUnspecified injury at c7 level of cervical spinal cord, sequela
S14.108AUnspecified injury at c8 level of cervical spinal cord, initial encounter
S14.108DUnspecified injury at c8 level of cervical spinal cord, subsequent encounter
S14.108SUnspecified injury at c8 level of cervical spinal cord, sequela
S14.109AUnspecified injury at unspecified level of cervical spinal cord, initial encounter
S14.109DUnspecified injury at unspecified level of cervical spinal cord, subsequent encounter
S14.109SUnspecified injury at unspecified level of cervical spinal cord, sequela
S14.111AComplete lesion at c1 level of cervical spinal cord, initial encounter
S14.111DComplete lesion at c1 level of cervical spinal cord, subsequent encounter
S14.111SComplete lesion at c1 level of cervical spinal cord, sequela
S14.112AComplete lesion at c2 level of cervical spinal cord, initial encounter
S14.112DComplete lesion at c2 level of cervical spinal cord, subsequent encounter
S14.112SComplete lesion at c2 level of cervical spinal cord, sequela
S14.113AComplete lesion at c3 level of cervical spinal cord, initial encounter
S14.113DComplete lesion at c3 level of cervical spinal cord, subsequent encounter
S14.113SComplete lesion at c3 level of cervical spinal cord, sequela
S14.114AComplete lesion at c4 level of cervical spinal cord, initial encounter
S14.114DComplete lesion at c4 level of cervical spinal cord, subsequent encounter
S14.114SComplete lesion at c4 level of cervical spinal cord, sequela
S14.115AComplete lesion at c5 level of cervical spinal cord, initial encounter
S14.115DComplete lesion at c5 level of cervical spinal cord, subsequent encounter
S14.115SComplete lesion at c5 level of cervical spinal cord, sequela
S14.116AComplete lesion at c6 level of cervical spinal cord, initial encounter
S14.116DComplete lesion at c6 level of cervical spinal cord, subsequent encounter
S14.116SComplete lesion at c6 level of cervical spinal cord, sequela
S14.117AComplete lesion at c7 level of cervical spinal cord, initial encounter
S14.117DComplete lesion at c7 level of cervical spinal cord, subsequent encounter
S14.117SComplete lesion at c7 level of cervical spinal cord, sequela
S14.118AComplete lesion at c8 level of cervical spinal cord, initial encounter
S14.118DComplete lesion at c8 level of cervical spinal cord, subsequent encounter
S14.118SComplete lesion at c8 level of cervical spinal cord, sequela
S14.119AComplete lesion at unspecified level of cervical spinal cord, initial encounter
S14.119DComplete lesion at unspecified level of cervical spinal cord, subsequent encounter
S14.119SComplete lesion at unspecified level of cervical spinal cord, sequela
S14.121ACentral Cord Syndrome at c1 level of cervical spinal cord, initial encounter
S14.121DCentral Cord Syndrome at c1 level of cervical spinal cord, subsequent encounter
S14.121SCentral Cord Syndrome at c1 level of cervical spinal cord, sequela
S14.122ACentral Cord Syndrome at c2 level of cervical spinal cord, initial encounter
S14.122DCentral Cord Syndrome at c2 level of cervical spinal cord, subsequent encounter
S14.122SCentral Cord Syndrome at c2 level of cervical spinal cord, sequela
S14.123ACentral Cord Syndrome at c3 level of cervical spinal cord, initial encounter
S14.123DCentral Cord Syndrome at c3 level of cervical spinal cord, subsequent encounter
S14.123SCentral Cord Syndrome at c3 level of cervical spinal cord, sequela
S14.124ACentral Cord Syndrome at c4 level of cervical spinal cord, initial encounter
S14.124DCentral Cord Syndrome at c4 level of cervical spinal cord, subsequent encounter
S14.124SCentral Cord Syndrome at c4 level of cervical spinal cord, sequela
S14.125ACentral Cord Syndrome at c5 level of cervical spinal cord, initial encounter
S14.125DCentral Cord Syndrome at c5 level of cervical spinal cord, subsequent encounter
S14.125SCentral Cord Syndrome at c5 level of cervical spinal cord, sequela
S14.126ACentral Cord Syndrome at c6 level of cervical spinal cord, initial encounter
S14.126DCentral Cord Syndrome at c6 level of cervical spinal cord, subsequent encounter
S14.126SCentral Cord Syndrome at c6 level of cervical spinal cord, sequela
S14.127ACentral Cord Syndrome at c7 level of cervical spinal cord, initial encounter
S14.127DCentral Cord Syndrome at c7 level of cervical spinal cord, subsequent encounter
S14.127SCentral Cord Syndrome at c7 level of cervical spinal cord, sequela
S14.128ACentral Cord Syndrome at c8 level of cervical spinal cord, initial encounter
S14.128DCentral Cord Syndrome at c8 level of cervical spinal cord, subsequent encounter
S14.128SCentral Cord Syndrome at c8 level of cervical spinal cord, sequela
S14.129ACentral Cord Syndrome at unspecified level of cervical spinal cord, initial encounter
S14.129DCentral Cord Syndrome at unspecified level of cervical spinal cord, subsequent encounter
S14.129SCentral Cord Syndrome at unspecified level of cervical spinal cord, sequela
S14.131AAnterior Cord Syndrome at c1 level of cervical spinal cord, initial encounter
S14.131DAnterior Cord Syndrome at c1 level of cervical spinal cord, subsequent encounter
S14.131SAnterior Cord Syndrome at c1 level of cervical spinal cord, sequela
S14.132AAnterior Cord Syndrome at c2 level of cervical spinal cord, initial encounter
S14.132DAnterior Cord Syndrome at c2 level of cervical spinal cord, subsequent encounter
S14.132SAnterior Cord Syndrome at c2 level of cervical spinal cord, sequela
S14.133AAnterior Cord Syndrome at c3 level of cervical spinal cord, initial encounter
S14.133DAnterior Cord Syndrome at c3 level of cervical spinal cord, subsequent encounter
S14.133SAnterior Cord Syndrome at c3 level of cervical spinal cord, sequela
S14.134AAnterior Cord Syndrome at c4 level of cervical spinal cord, initial encounter
S14.134DAnterior Cord Syndrome at c4 level of cervical spinal cord, subsequent encounter
S14.134SAnterior Cord Syndrome at c4 level of cervical spinal cord, sequela
S14.135AAnterior Cord Syndrome at c5 level of cervical spinal cord, initial encounter
S14.135DAnterior Cord Syndrome at c5 level of cervical spinal cord, subsequent encounter
S14.135SAnterior Cord Syndrome at c5 level of cervical spinal cord, sequela
S14.136AAnterior Cord Syndrome at c6 level of cervical spinal cord, initial encounter
S14.136DAnterior Cord Syndrome at c6 level of cervical spinal cord, subsequent encounter
S14.136SAnterior Cord Syndrome at c6 level of cervical spinal cord, sequela
S14.137AAnterior Cord Syndrome at c7 level of cervical spinal cord, initial encounter
S14.137DAnterior Cord Syndrome at c7 level of cervical spinal cord, subsequent encounter
S14.137SAnterior Cord Syndrome at c7 level of cervical spinal cord, sequela
S14.138AAnterior Cord Syndrome at c8 level of cervical spinal cord, initial encounter
S14.138DAnterior Cord Syndrome at c8 level of cervical spinal cord, subsequent encounter
S14.138SAnterior Cord Syndrome at c8 level of cervical spinal cord, sequela
S14.139AAnterior Cord Syndrome at unspecified level of cervical spinal cord, initial encounter
S14.139DAnterior Cord Syndrome at unspecified level of cervical spinal cord, subsequent encounter
S14.139SAnterior Cord Syndrome at unspecified level of cervical spinal cord, sequela
S14.141ABrown-Sequard Syndrome at c1 level of cervical spinal cord, initial encounter
S14.141DBrown-Sequard Syndrome at c1 level of cervical spinal cord, subsequent encounter
S14.141SBrown-Sequard Syndrome at c1 level of cervical spinal cord, sequela
S14.142ABrown-Sequard Syndrome at c2 level of cervical spinal cord, initial encounter
S14.142DBrown-Sequard Syndrome at c2 level of cervical spinal cord, subsequent encounter
S14.142SBrown-Sequard Syndrome at c2 level of cervical spinal cord, sequela
S14.143ABrown-Sequard Syndrome at c3 level of cervical spinal cord, initial encounter
S14.143DBrown-Sequard Syndrome at c3 level of cervical spinal cord, subsequent encounter
S14.143SBrown-Sequard Syndrome at c3 level of cervical spinal cord, sequela
S14.144ABrown-Sequard Syndrome at c4 level of cervical spinal cord, initial encounter
S14.144DBrown-Sequard Syndrome at c4 level of cervical spinal cord, subsequent encounter
S14.144SBrown-Sequard Syndrome at c4 level of cervical spinal cord, sequela
S14.145ABrown-Sequard Syndrome at c5 level of cervical spinal cord, initial encounter
S14.145DBrown-Sequard Syndrome at c5 level of cervical spinal cord, subsequent encounter
S14.145SBrown-Sequard Syndrome at c5 level of cervical spinal cord, sequela
S14.146ABrown-Sequard Syndrome at c6 level of cervical spinal cord, initial encounter
S14.146DBrown-Sequard Syndrome at c6 level of cervical spinal cord, subsequent encounter
S14.146SBrown-Sequard Syndrome at c6 level of cervical spinal cord, sequela
S14.147ABrown-Sequard Syndrome at c7 level of cervical spinal cord, initial encounter
S14.147DBrown-Sequard Syndrome at c7 level of cervical spinal cord, subsequent encounter
S14.147SBrown-Sequard Syndrome at c7 level of cervical spinal cord, sequela
S14.148ABrown-Sequard Syndrome at c8 level of cervical spinal cord, initial encounter
S14.148DBrown-Sequard Syndrome at c8 level of cervical spinal cord, subsequent encounter
S14.148SBrown-Sequard Syndrome at c8 level of cervical spinal cord, sequela
S14.149ABrown-Sequard Syndrome at unspecified level of cervical spinal cord, initial encounter
S14.149DBrown-Sequard Syndrome at unspecified level of cervical spinal cord, subsequent encounter
S14.149SBrown-Sequard Syndrome at unspecified level of cervical spinal cord, sequela
S14.151AOther inComplete lesion at c1 level of cervical spinal cord, initial encounter
S14.151DOther inComplete lesion at c1 level of cervical spinal cord, subsequent encounter
S14.151SOther inComplete lesion at c1 level of cervical spinal cord, sequela


Version Effective Date: 10/01/2019
Version Issued Date: 10/01/2019
Version Reissued Date: 11/21/2019

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