G456

PDF page 517 / J103

Schedule A
         Complete procedure i.e. conduction studies on two or more nerves presumed to be involved in
         the disease process together with EMG studies of appropriate muscles, as necessary and/or
         detailed studies of neuromuscular transmission. It also includes as necessary study of normal
         nerve and/or opposite side for comparison.
   G455        - technical component ..........................................................   31.80
   G456        - professional component .....................................................             120.00
        Schedule B
         Limited procedure i.e. conduction studies on a single nerve (motor and/or sensory conduction)
         and/or limited EMG studies of the involved muscle(s) and or limited neuromuscular
         transmission study.
   G466        - technical component ..........................................................   21.40
   G457        - professional component ....................................................               74.40

PDF page 518 / J104

Schedule C
     Complex neuromuscular electrodiagnostic testing requiring a minimum of 60 minutes of direct
     physician involvement.
     The testing must include ten (10) or more electrodiagnostic studies, performed through any
     combination of the following:
    a. Nerve conduction studies
    b. Late motor response studies
    c. Needle electromyography of distinct muscles
    d. Repetitive stimulation of muscle-nerve pairs
    e. Autonomic function studies
    Note:
    For the purposes of G471/G473, the cranial, cervical, thoracic and lumbosacral regions
    represent separate segments.
 G471   - technical component ..........................................................      31.80
 G473   - professional component, when physician performs EMG
          and/or performs or supervises nerve conduction studies and
          interprets the results ..........................................................               275.00
    Payment rules:
    1. G473 is only eligible for payment when a minimum of 60 minutes of direct physician
      involvement has been rendered in relation to the service and to the exclusion of all other
      work.
    2. G473 is not eligible for payment with G456 or G457 same patient same day.
    3. G471 is not eligible for payment with G455 or G466 same patient same day.
    4. G458 is eligible for payment in addition to G473 only when the time necessary to perform
      the G458 service is not included in the minimum time requirement for G473.
    Medical record requirements:
    The start and stop time must be recorded in the patient’s medical record or the service is not
    eligible for payment. See General Preamble GP7 and GP55 for definitions and time-keeping
    requirements.
    [Commentary:
    Complex neuromuscular disorders where Schedule C nerve conduction studies/
    electromyography may be appropriate include demyelinating neuropathies, mononeuritis
    multiplex, motor neuron disease, brachial/lumbosacral plexopathies and neuromuscular
    transmission disorders.]

Master, record 2167. Record Layout PDF, page 1.

G45620260401999999990000120000000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.