Notification



Notification Issue Date:



Policy Attachment


Attachment to Policy # 07.03.09p


Attachment:K

Policy #:07.03.09p

Description:ICD-10 Codes

Title:Electromyography (EMG) Studies: Needle EMG, Surface EMG (SEMG)


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 FOLLOWING CODES REPRESENT INDICATIONS THAT SUPPORT MEDICAL NECESSITY
ICD-10Code Narrative
S94.31XAInjury of cutaneous sensory nerve at ankle and foot level, right leg, initial encounter
S94.31XDINJURY OF CUTANEOUS SENSORY NERVE AT ANKLE AND FOOT LEVEL, RIGHT LEG, SUBSEQUENT ENCOUNTER
S94.31XSINJURY OF CUTANEOUS SENSORY NERVE AT ANKLE AND FOOT LEVEL, RIGHT LEG, SEQUELA
S94.32XAInjury of cutaneous sensory nerve at ankle and foot level, left leg, initial encounter
S94.32XDINJURY OF CUTANEOUS SENSORY NERVE AT ANKLE AND FOOT LEVEL, LEFT LEG, SUBSEQUENT ENCOUNTER
S94.32XSINJURY OF CUTANEOUS SENSORY NERVE AT ANKLE AND FOOT LEVEL, LEFT LEG, SEQUELA
S94.8X1AInjury of other nerves at ankle and foot level, right leg, initial encounter
S94.8X1DINJURY OF OTHER NERVES AT ANKLE AND FOOT LEVEL, RIGHT LEG, SUBSEQUENT ENCOUNTER
S94.8X1SINJURY OF OTHER NERVES AT ANKLE AND FOOT LEVEL, RIGHT LEG, SEQUELA
S94.8X2AInjury of other nerves at ankle and foot level, left leg, initial encounter
S94.8X2DINJURY OF OTHER NERVES AT ANKLE AND FOOT LEVEL, LEFT LEG, SUBSEQUENT ENCOUNTER
S94.8X2SINJURY OF OTHER NERVES AT ANKLE AND FOOT LEVEL, LEFT LEG, SEQUELA
S94.8X9AInjury of other nerves at ankle and foot level, unspecified leg, initial encounter
S94.8X9DINJURY OF OTHER NERVES AT ANKLE AND FOOT LEVEL, UNSPECIFIED LEG, SUBSEQUENT ENCOUNTER
S94.8X9SINJURY OF OTHER NERVES AT ANKLE AND FOOT LEVEL, UNSPECIFIED LEG, SEQUELA
S94.90XAInjury of unspecified nerve at ankle and foot level, unspecified leg, initial encounter
S94.90XDINJURY OF UNSPECIFIED NERVE AT ANKLE AND FOOT LEVEL, UNSPECIFIED LEG, SUBSEQUENT ENCOUNTER
S94.90XSINJURY OF UNSPECIFIED NERVE AT ANKLE AND FOOT LEVEL, UNSPECIFIED LEG, SEQUELA
S94.91XAInjury of unspecified nerve at ankle and foot level, right leg, initial encounter
S94.91XDINJURY OF UNSPECIFIED NERVE AT ANKLE AND FOOT LEVEL, RIGHT LEG, SUBSEQUENT ENCOUNTER
S94.91XSINJURY OF UNSPECIFIED NERVE AT ANKLE AND FOOT LEVEL, RIGHT LEG, SEQUELA
S94.92XAInjury of unspecified nerve at ankle and foot level, left leg, initial encounter
S94.92XDINJURY OF UNSPECIFIED NERVE AT ANKLE AND FOOT LEVEL, LEFT LEG, SUBSEQUENT ENCOUNTER
S94.92XSINJURY OF UNSPECIFIED NERVE AT ANKLE AND FOOT LEVEL, LEFT LEG, SEQUELA




Version Effective Date: 10/01/2019
Version Issued Date: 10/02/2019
Version Reissued Date: 11/20/2019

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