Noridian EMG Denials

Members & Publications


September 22, 2016

AAPM&R received notice that members are receiving denials for needle EMGs even when using appropriate ICD-10 codes, referring to a new Noridian LCD released June 2016. Noridian erroneously put an edit in place in June that required a Group II diagnosis code for all needle EMGs, even if they are performed with an NCS. This group is mostly injury codes, and the edit is not appropriate. Group one should be for NCS and needle EMG together; Group 2 for NCS and needle EMG together OR needle EMG alone. We have been advised that members should appeal all incorrect denials that they receive. Appeals should be successful without the need to change the diagnosis code. 

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.