G471

PDF page 25 / GP11

Payment for Diagnostic and Therapeutic Services Rendered at a Hospital
  The technical component of a diagnostic and therapeutic service listed below and rendered in a
  hospital is payable at 86.10% of the listed fee in the column headed “T”.
  G104A, G111A, G121A, G127A, G140A, G143A, G146A, G149A, G152A, G153A, G167A,
  G174A,G181A, G209A, G284A, G308A, G310A, G311A, G315A, G414A, G440A, G441A, G442A,
  G443A,G448A, G451A, G455A, G466A, G471A, G519A, G540A, G541A, G542A, G544A, G554A,
  G570A,G574A, G582A, G585A, G647A, G648A, G651A, G652A, G654A, G655A, G682A, G683A,
  G684A,G685A, G686A, G687A, G688A, G689A, G694A, G695A, G815A, G850A, G851A, G852A,
  G853A,G854A, G855A, G856A, G857A, G858A, J301B, J304B, J324B, J327B

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 2182. Record Layout PDF, page 1.

G47120260401999999990000031800000000000000000000000000000000000000000000000

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.