Notification



Notification Issue Date:



Policy Attachment

Attachment to Policy # MA07.033f


Attachment:H

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
S14.152AOther incomplete lesion at c2 level of cervical spinal cord, initial encounter
S14.152DOther incomplete lesion at c2 level of cervical spinal cord, subsequent encounter
S14.152SOther incomplete lesion at c2 level of cervical spinal cord, sequela
S14.153AOther incomplete lesion at c3 level of cervical spinal cord, initial encounter
S14.153DOther incomplete lesion at c3 level of cervical spinal cord, subsequent encounter
S14.153SOther incomplete lesion at c3 level of cervical spinal cord, sequela
S14.154AOther incomplete lesion at c4 level of cervical spinal cord, initial encounter
S14.154DOther incomplete lesion at c4 level of cervical spinal cord, subsequent encounter
S14.154SOther incomplete lesion at c4 level of cervical spinal cord, sequela
S14.155AOther incomplete lesion at c5 level of cervical spinal cord, initial encounter
S14.155DOther incomplete lesion at c5 level of cervical spinal cord, subsequent encounter
S14.155SOther incomplete lesion at c5 level of cervical spinal cord, sequela
S14.156AOther incomplete lesion at c6 level of cervical spinal cord, initial encounter
S14.156DOther incomplete lesion at c6 level of cervical spinal cord, subsequent encounter
S14.156SOther incomplete lesion at c6 level of cervical spinal cord, sequela
S14.157AOther incomplete lesion at c7 level of cervical spinal cord, initial encounter
S14.157DOther incomplete lesion at c7 level of cervical spinal cord, subsequent encounter
S14.157SOther incomplete lesion at c7 level of cervical spinal cord, sequela
S14.158AOther incomplete lesion at c8 level of cervical spinal cord, initial encounter
S14.158DOther incomplete lesion at c8 level of cervical spinal cord, subsequent encounter
S14.158SOther incomplete lesion at c8 level of cervical spinal cord, sequela
S14.159AOther incomplete lesion at unspecified level of cervical spinal cord, initial encounter
S14.159DOther incomplete lesion at unspecified level of cervical spinal cord, subsequent encounter
S14.159SOther incomplete lesion at unspecified level of cervical spinal cord, sequela
S14.2XXAInjury of nerve root of cervical spine, initial encounter
S14.2XXDInjury of nerve root of cervical spine, subsequent encounter
S14.2XXSInjury of nerve root of cervical spine, sequela
S14.3XXAInjury of brachial plexus, initial encounter
S14.3XXDInjury of brachial plexus, subsequent encounter
S14.3XXSInjury of brachial plexus, sequela
S14.4XXAInjury of peripheral nerves of neck, initial encounter
S14.4XXDInjury of peripheral nerves of neck, subsequent encounter
S14.4XXSInjury of peripheral nerves of neck, sequela
S14.5XXAInjury of cervical sympathetic nerves, initial encounter
S14.5XXDInjury of cervical sympathetic nerves, subsequent encounter
S14.5XXSInjury of cervical sympathetic nerves, sequela
S14.8XXAInjury of other specified nerves of neck, initial encounter
S14.8XXDInjury of other specified nerves of neck, subsequent encounter
S14.8XXSInjury of other specified nerves of neck, sequela
S14.9XXAInjury of unspecified nerves of neck, initial encounter
S14.9XXDInjury of unspecified nerves of neck, subsequent encounter
S14.9XXSInjury of unspecified nerves of neck, sequela
S22.009AUnspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.009BUnspecified fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.009DUnspecified fracture of unspecified thoracic vertebra, subsequent encounter for fracture with routine healing
S22.009GUnspecified fracture of unspecified thoracic vertebra, subsequent encounter for fracture with delayed healing
S22.009KUnspecified fracture of unspecified thoracic vertebra, subsequent encounter for fracture with nonunion
S22.009SUnspecified fracture of unspecified thoracic vertebra, sequela
S22.019AUnspecified fracture of first thoracic vertebra, initial encounter for closed fracture
S22.019BUnspecified fracture of first thoracic vertebra, initial encounter for open fracture
S22.019DUnspecified fracture of first thoracic vertebra, subsequent encounter for fracture with routine healing
S22.019GUnspecified fracture of first thoracic vertebra, subsequent encounter for fracture with delayed healing
S22.019KUnspecified fracture of first thoracic vertebra, subsequent encounter for fracture with nonunion
S22.019SUnspecified fracture of first thoracic vertebra, sequela
S22.029AUnspecified fracture of second thoracic vertebra, initial encounter for closed fracture
S22.029BUnspecified fracture of second thoracic vertebra, initial encounter for open fracture
S22.029DUnspecified fracture of second thoracic vertebra, subsequent encounter for fracture with routine healing
S22.029GUnspecified fracture of second thoracic vertebra, subsequent encounter for fracture with delayed healing
S22.029KUnspecified fracture of second thoracic vertebra, subsequent encounter for fracture with nonunion
S22.029SUnspecified fracture of second thoracic vertebra, sequela
S22.039AUnspecified fracture of third thoracic vertebra, initial encounter for closed fracture
S22.039BUnspecified fracture of third thoracic vertebra, initial encounter for open fracture
S22.039DUnspecified fracture of third thoracic vertebra, subsequent encounter for fracture with routine healing
S22.039GUnspecified fracture of third thoracic vertebra, subsequent encounter for fracture with delayed healing
S22.039KUnspecified fracture of third thoracic vertebra, subsequent encounter for fracture with nonunion
S22.039SUnspecified fracture of third thoracic vertebra, sequela
S22.049AUnspecified fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.049BUnspecified fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.049DUnspecified fracture of fourth thoracic vertebra, subsequent encounter for fracture with routine healing
S22.049GUnspecified fracture of fourth thoracic vertebra, subsequent encounter for fracture with delayed healing
S22.049KUnspecified fracture of fourth thoracic vertebra, subsequent encounter for fracture with nonunion
S22.049SUnspecified fracture of fourth thoracic vertebra, sequela
S22.059AUnspecified fracture of t5-t6 vertebra, initial encounter for closed fracture
S22.059BUnspecified fracture of t5-t6 vertebra, initial encounter for open fracture
S22.059DUnspecified fracture of t5-t6 vertebra, subsequent encounter for fracture with routine healing
S22.059GUnspecified fracture of t5-t6 vertebra, subsequent encounter for fracture with delayed healing
S22.059KUnspecified fracture of t5-t6 vertebra, subsequent encounter for fracture with nonunion
S22.059SUnspecified fracture of t5-t6 vertebra, sequela
S22.069AUnspecified fracture of t7-t8 vertebra, initial encounter for closed fracture
S22.069BUnspecified fracture of t7-t8 vertebra, initial encounter for open fracture
S22.069DUnspecified fracture of t7-t8 vertebra, subsequent encounter for fracture with routine healing
S22.069GUnspecified fracture of t7-t8 vertebra, subsequent encounter for fracture with delayed healing
S22.069KUnspecified fracture of t7-t8 vertebra, subsequent encounter for fracture with nonunion
S22.069SUnspecified fracture of t7-t8 vertebra, sequela
S22.079AUnspecified fracture of t9-t10 vertebra, initial encounter for closed fracture
S22.079BUnspecified fracture of t9-t10 vertebra, initial encounter for open fracture
S22.079DUnspecified fracture of t9-t10 vertebra, subsequent encounter for fracture with routine healing
S22.079GUnspecified fracture of t9-t10 vertebra, subsequent encounter for fracture with delayed healing
S22.079KUnspecified fracture of t9-t10 vertebra, subsequent encounter for fracture with nonunion
S22.079SUnspecified fracture of t9-t10 vertebra, sequela
S22.089AUnspecified fracture of t11-t12 vertebra, initial encounter for closed fracture
S22.089BUnspecified fracture of t11-t12 vertebra, initial encounter for open fracture
S22.089DUnspecified fracture of t11-t12 vertebra, subsequent encounter for fracture with routine healing
S22.089GUnspecified fracture of t11-t12 vertebra, subsequent encounter for fracture with delayed healing
S22.089KUnspecified fracture of t11-t12 vertebra, subsequent encounter for fracture with nonunion
S22.089SUnspecified fracture of t11-t12 vertebra, sequela
S24.0XXAConcussion and edema of thoracic spinal cord, initial encounter
S24.0XXDConcussion and edema of thoracic spinal cord, subsequent encounter
S24.0XXSConcussion and edema of thoracic spinal cord, sequela
S24.101AUnspecified injury at t1 level of thoracic spinal cord, initial encounter
S24.101DUnspecified injury at t1 level of thoracic spinal cord, subsequent encounter
S24.101SUnspecified injury at t1 level of thoracic spinal cord, sequela
S24.102AUnspecified injury at t2-t6 level of thoracic spinal cord, initial encounter
S24.102DUnspecified injury at t2-t6 level of thoracic spinal cord, subsequent encounter
S24.102SUnspecified injury at t2-t6 level of thoracic spinal cord, sequela
S24.103AUnspecified injury at t7-t10 level of thoracic spinal cord, initial encounter
S24.103DUnspecified injury at t7-t10 level of thoracic spinal cord, subsequent encounter
S24.103SUnspecified injury at t7-t10 level of thoracic spinal cord, sequela
S24.104AUnspecified injury at t11-t12 level of thoracic spinal cord, initial encounter
S24.104DUnspecified injury at t11-t12 level of thoracic spinal cord, subsequent encounter
S24.104SUnspecified injury at t11-t12 level of thoracic spinal cord, sequela
S24.109AUnspecified injury at unspecified level of thoracic spinal cord, initial encounter
S24.109DUnspecified injury at unspecified level of thoracic spinal cord, subsequent encounter
S24.109SUnspecified injury at unspecified level of thoracic spinal cord, sequela
S24.111AComplete lesion at t1 level of thoracic spinal cord, initial encounter
S24.111DComplete lesion at t1 level of thoracic spinal cord, subsequent encounter
S24.111SComplete lesion at t1 level of thoracic spinal cord, sequela
S24.112AComplete lesion at t2-t6 level of thoracic spinal cord, initial encounter
S24.112DComplete lesion at t2-t6 level of thoracic spinal cord, subsequent encounter
S24.112SComplete lesion at t2-t6 level of thoracic spinal cord, sequela
S24.113AComplete lesion at t7-t10 level of thoracic spinal cord, initial encounter
S24.113DComplete lesion at t7-t10 level of thoracic spinal cord, subsequent encounter
S24.113SComplete lesion at t7-t10 level of thoracic spinal cord, sequela
S24.114AComplete lesion at t11-t12 level of thoracic spinal cord, initial encounter
S24.114DComplete lesion at t11-t12 level of thoracic spinal cord, subsequent encounter
S24.114SComplete lesion at t11-t12 level of thoracic spinal cord, sequela
S24.119AComplete lesion at unspecified level of thoracic spinal cord, initial encounter
S24.119DComplete lesion at unspecified level of thoracic spinal cord, subsequent encounter
S24.119SComplete lesion at unspecified level of thoracic spinal cord, sequela
S24.131AAnterior Cord Syndrome at t1 level of thoracic spinal cord, initial encounter
S24.131DAnterior Cord Syndrome at t1 level of thoracic spinal cord, subsequent encounter
S24.131SAnterior Cord Syndrome at t1 level of thoracic spinal cord, sequela
S24.132AAnterior Cord Syndrome at t2-t6 level of thoracic spinal cord, initial encounter
S24.132DAnterior Cord Syndrome at t2-t6 level of thoracic spinal cord, subsequent encounter
S24.132SAnterior Cord Syndrome at t2-t6 level of thoracic spinal cord, sequela
S24.133AAnterior Cord Syndrome at t7-t10 level of thoracic spinal cord, initial encounter
S24.133DAnterior Cord Syndrome at t7-t10 level of thoracic spinal cord, subsequent encounter
S24.133SAnterior Cord Syndrome at t7-t10 level of thoracic spinal cord, sequela
S24.134AAnterior Cord Syndrome at t11-t12 level of thoracic spinal cord, initial encounter
S24.134DAnterior Cord Syndrome at t11-t12 level of thoracic spinal cord, subsequent encounter
S24.134SAnterior Cord Syndrome at t11-t12 level of thoracic spinal cord, sequela
S24.139AAnterior Cord Syndrome at unspecified level of thoracic spinal cord, initial encounter
S24.139DAnterior Cord Syndrome at unspecified level of thoracic spinal cord, subsequent encounter
S24.139SAnterior Cord Syndrome at unspecified level of thoracic spinal cord, sequela
S24.141ABrown-Sequard Syndrome at t1 level of thoracic spinal cord, initial encounter
S24.141DBrown-Sequard Syndrome at t1 level of thoracic spinal cord, subsequent encounter
S24.141SBrown-Sequard Syndrome at t1 level of thoracic spinal cord, sequela
S24.142ABrown-Sequard Syndrome at t2-t6 level of thoracic spinal cord, initial encounter
S24.142DBrown-Sequard Syndrome at t2-t6 level of thoracic spinal cord, subsequent encounter
S24.142SBrown-Sequard Syndrome at t2-t6 level of thoracic spinal cord, sequela
S24.143ABrown-Sequard Syndrome at t7-t10 level of thoracic spinal cord, initial encounter
S24.143DBrown-Sequard Syndrome at t7-t10 level of thoracic spinal cord, subsequent encounter
S24.143SBrown-Sequard Syndrome at t7-t10 level of thoracic spinal cord, sequela
S24.144ABrown-Sequard Syndrome at t11-t12 level of thoracic spinal cord, initial encounter
S24.144DBrown-Sequard Syndrome at t11-t12 level of thoracic spinal cord, subsequent encounter
S24.144SBrown-Sequard Syndrome at t11-t12 level of thoracic spinal cord, sequela
S24.149ABrown-Sequard Syndrome at unspecified level of thoracic spinal cord, initial encounter
S24.149DBrown-Sequard Syndrome at unspecified level of thoracic spinal cord, subsequent encounter
S24.149SBrown-Sequard Syndrome at unspecified level of thoracic spinal cord, sequela
S24.151AOther incomplete lesion at t1 level of thoracic spinal cord, initial encounter
S24.151DOther incomplete lesion at t1 level of thoracic spinal cord, subsequent encounter
S24.151SOther incomplete lesion at t1 level of thoracic spinal cord, sequela
S24.152AOther incomplete lesion at t2-t6 level of thoracic spinal cord, initial encounter
S24.152DOther incomplete lesion at t2-t6 level of thoracic spinal cord, subsequent encounter
S24.152SOther incomplete lesion at t2-t6 level of thoracic spinal cord, sequela
S24.153AOther incomplete lesion at t7-t10 level of thoracic spinal cord, initial encounter
S24.153DOther incomplete lesion at t7-t10 level of thoracic spinal cord, subsequent encounter
S24.153SOther incomplete lesion at t7-t10 level of thoracic spinal cord, sequela
S24.154AOther incomplete lesion at t11-t12 level of thoracic spinal cord, initial encounter
S24.154DOther incomplete lesion at t11-t12 level of thoracic spinal cord, subsequent encounter
S24.154SOther incomplete lesion at t11-t12 level of thoracic spinal cord, sequela
S24.159AOther incomplete lesion at unspecified level of thoracic spinal cord, initial encounter
S24.159DOther incomplete lesion at unspecified level of thoracic spinal cord, subsequent encounter
S24.159SOther incomplete lesion at unspecified level of thoracic spinal cord, sequela
S24.2XXAInjury of nerve root of thoracic spine, initial encounter
S24.2XXDInjury of nerve root of thoracic spine, subsequent encounter
S24.2XXSInjury of nerve root of thoracic spine, sequela
S24.3XXAInjury of peripheral nerves of thorax, initial encounter
S24.3XXDInjury of peripheral nerves of thorax, subsequent encounter
S24.3XXSInjury of peripheral nerves of thorax, sequela
S24.4XXAInjury of thoracic sympathetic nervous system, initial encounter
S24.4XXDInjury of thoracic sympathetic nervous system, subsequent encounter
S24.4XXSInjury of thoracic sympathetic nervous system, sequela
S24.8XXAInjury of other specified nerves of thorax, initial encounter
S24.8XXDInjury of other specified nerves of thorax, subsequent encounter
S24.8XXSInjury of other specified nerves of thorax, sequela
S24.9XXAInjury of unspecified nerve of thorax, initial encounter
S24.9XXDInjury of unspecified nerve of thorax, subsequent encounter
S24.9XXSInjury of unspecified nerve of thorax, sequela
S32.009AUnspecified fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.009BUnspecified fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.009DUnspecified fracture of unspecified lumbar vertebra, subsequent encounter for fracture with routine healing
S32.009GUnspecified fracture of unspecified lumbar vertebra, subsequent encounter for fracture with delayed healing
S32.009KUnspecified fracture of unspecified lumbar vertebra, subsequent encounter for fracture with nonunion
S32.009SUnspecified fracture of unspecified lumbar vertebra, sequela
S32.019AUnspecified fracture of first lumbar vertebra, initial encounter for closed fracture
S32.019BUnspecified fracture of first lumbar vertebra, initial encounter for open fracture
S32.019DUnspecified fracture of first lumbar vertebra, subsequent encounter for fracture with routine healing
S32.019GUnspecified fracture of first lumbar vertebra, subsequent encounter for fracture with delayed healing
S32.019KUnspecified fracture of first lumbar vertebra, subsequent encounter for fracture with nonunion
S32.019SUnspecified fracture of first lumbar vertebra, sequela
S32.029AUnspecified fracture of second lumbar vertebra, initial encounter for closed fracture
S32.029BUnspecified fracture of second lumbar vertebra, initial encounter for open fracture
S32.029DUnspecified fracture of second lumbar vertebra, subsequent encounter for fracture with routine healing
S32.029GUnspecified fracture of second lumbar vertebra, subsequent encounter for fracture with delayed healing
S32.029KUnspecified fracture of second lumbar vertebra, subsequent encounter for fracture with nonunion
S32.029SUnspecified fracture of second lumbar vertebra, sequela
S32.039AUnspecified fracture of third lumbar vertebra, initial encounter for closed fracture
S32.039BUnspecified fracture of third lumbar vertebra, initial encounter for open fracture
S32.039DUnspecified fracture of third lumbar vertebra, subsequent encounter for fracture with routine healing
S32.039GUnspecified fracture of third lumbar vertebra, subsequent encounter for fracture with delayed healing
S32.039KUnspecified fracture of third lumbar vertebra, subsequent encounter for fracture with nonunion
S32.039SUnspecified fracture of third lumbar vertebra, sequela
S32.049AUnspecified fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.049BUnspecified fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.049DUnspecified fracture of fourth lumbar vertebra, subsequent encounter for fracture with routine healing
S32.049GUnspecified fracture of fourth lumbar vertebra, subsequent encounter for fracture with delayed healing
S32.049KUnspecified fracture of fourth lumbar vertebra, subsequent encounter for fracture with nonunion
S32.049SUnspecified fracture of fourth lumbar vertebra, sequela
S32.059AUnspecified fracture of fifth lumbar vertebra, initial encounter for closed fracture


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

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Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.