G458

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.]

PDF page 519 / J105

Single fibre electromyography
   G458 Single fibre electromyography ................................................    275.00
     CHEMODENERVATION INJECTION
      Chemodenervation injection of individual peripheral motor nerve using phenol, ethyl alcohol or
      similar non-anaesthetic chemical agents for reduction of focal spasticity, and may include
      electromyography (EMG) guidance of injection(s).
   G485 - first major nerve and/or branches.......................................                   45.45
   G486    - each additional major nerve and/or its branches same day
             ................................................................................... add 28.50
     Repeat or additional procedure within 30 days of previous chemodenervation injection
   G487 - first major nerve and/or its branches ..................................                   28.50
   G488   - each additional major nerve and/or its branches same day
              .................................................................................. add 18.80
          Note:
          1.Use nerve block listings under Nerve Blocks sub-section if anaesthetic agents are used
            instead of phenol or alcohol or similar non-anaesthetic chemical agents.
          2.Chemodenervation injection into same muscle same day as botulinum toxin is an insured
            service payable at nil.

Master, record 2169. Record Layout PDF, page 1.

G45820260401999999990000275000000000000000000000000000000000000000000000000

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.