Billing and Coding: Nerve Conduction Studies and Electromyography

NC‑stat® System testing (CPT 95905) is covered only when the beneficiary has a high pre-test or prior probability of Carpal Tunnel Syndrome and must be billed with diagnosis code G56.01, G56.02, or G56.03; coverage is limited to one service per arm. Claims must include valid ICD‑10 diagnosis codes and required documentation (ordering provider assessment, history, test results, signed notes, and detailed NCS data); other diagnosis codes will be denied as not medically necessary. Billing is subject to NCCI/OPPS edits and ABN modifier rules (GA/GX/GY/GZ) with specific Part A MAC requirements (e.g., occurrence code 32 and CMS‑R‑131 when applicable).

"NC-stat® System (alone) is allowed when the beneficiary has a high pre-test probability or prior probability of Carpal Tunnel Syndrome, using CPT 95905."

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