Notification



Notification Issue Date:



Policy Attachment



Attachment to Policy # 07.03.18o


Attachment:E

Policy #:07.03.18o

Description:ICD-10 Codes

Title:Nerve Conduction Studies (NCS) and Related Electrodiagnostic Studies


Inclusion of a code in this table does not imply reimbursement. Eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.

The codes listed below are updated on a regular basis, in accordance with nationally accepted coding guidelines. Therefore, this policy applies to any and all future applicable coding changes, revisions, or updates.

In order to ensure optimal reimbursement, all health care services, devices, and pharmaceuticals should be reported using the billing codes and modifiers that most accurately represent the services rendered, unless otherwise directed by the Company.


THE FOLLOWING CODES REPRESENT INDICATIONS THAT SUPPORT MEDICAL NECESSITY
ICD-10 Code Narrative
M48.27Kissing spine, lumbosacral region
M48.30Traumatic spondylopathy, site unspecified
M48.31Traumatic spondylopathy, occipito-atlanto-axial region
M48.32Traumatic spondylopathy, cervical region
M48.33Traumatic spondylopathy, cervicothoracic region
M48.34Traumatic spondylopathy, thoracic region
M48.35Traumatic spondylopathy, thoracolumbar region
M48.36Traumatic spondylopathy, lumbar region
M48.37Traumatic spondylopathy, lumbosacral region
M48.38Traumatic spondylopathy, sacral and sacrococcygeal region
M48.9Spondylopathy, unspecified
M50.00Cervical disc disorder with myelopathy, unspecified cervical region
M50.01Cervical disc disorder with myelopathy, high cervical region
M50.020Cervical disc disorder with myelopathy, mid-cervical region, unspecified level
M50.021 Cervical disc disorder at C4-C5 level with myelopathy
M50.022 Cervical disc disorder at C5-C6 level with myelopathy
M50.023Cervical disc disorder at C6-C7 level with myelopathy
M50.03Cervical disc disorder with myelopathy, cervicothoracic region
M50.10Cervical disc disorder with radiculopathy, unspecified cervical region
M50.11Cervical disc disorder with radiculopathy, high cervical region
M50.120Mid-cervical disc disorder, unspecified level
M50.121Cervical disc disorder at C4-C5 level with radiculopathy
M50.122Cervical disc disorder at C5-C6 level with radiculopathy
M50.123Cervical disc disorder at C6-C7 level with radiculopathy
M50.13Cervical disc disorder with radiculopathy, cervicothoracic region
M50.20Other cervical disc displacement, unspecified cervical region
M50.21Other cervical disc displacement, high cervical region
M50.220Other cervical disc displacement, mid-cervical region, unspecified level
M50.221Other cervical disc displacement at C4-C5 level
M50.222Other cervical disc displacement at C5-C6 level
M50.223Other cervical disc displacement at C6-C7 level
M50.23Other cervical disc displacement, cervicothoracic region
M50.30Other cervical disc degeneration, unspecified cervical region
M50.31Other cervical disc degeneration, high cervical region
M50.320Other cervical disc degeneration, mid-cervical region, unspecified level
M50.321Other cervical disc degeneration at C4-C5 level
M50.322Other cervical disc degeneration at C5-C6 level
M50.323Other cervical disc degeneration at C6-C7 level
M50.33Other cervical disc degeneration, cervicothoracic region
M50.80Other cervical disc disorders, unspecified cervical region
M50.81Other cervical disc disorders, high cervical region
M50.820Other cervical disc disorders, mid-cervical region, unspecified level
M50.821Other cervical disc disorders at C4-C5 level
M50.822Other cervical disc disorders at C5-C6 level
M50.823Other cervical disc disorders at C6-C7 level
M50.83Other cervical disc disorders, cervicothoracic region
M50.90Cervical disc disorder, unspecified, unspecified cervical region
M50.91Cervical disc disorder, unspecified, high cervical region
M50.920Unspecified cervical disc disorder, mid-cervical region, unspecified level
M50.921Unspecified cervical disc disorder at C4-C5 level
M50.922Unspecified cervical disc disorder at C5-C6 level
M50.923Unspecified cervical disc disorder at C6-C7 level
M50.93Cervical disc disorder, unspecified, cervicothoracic region
M51.04Intervertebral disc disorders with myelopathy, thoracic region
M51.05Intervertebral disc disorders with myelopathy, thoracolumbar region
M51.06Intervertebral disc disorders with myelopathy, lumbar region
M51.14Intervertebral disc disorders with radiculopathy, thoracic region
M51.15Intervertebral disc disorders with radiculopathy, thoracolumbar region
M51.16Intervertebral disc disorders with radiculopathy, lumbar region
M51.17Intervertebral disc disorders with radiculopathy, lumbosacral region
M51.24Other intervertebral disc displacement, thoracic region
M51.25Other intervertebral disc displacement, thoracolumbar region
M51.26Other intervertebral disc displacement, lumbar region
M51.27Other intervertebral disc displacement, lumbosacral region
M51.34Other intervertebral disc degeneration, thoracic region
M51.35Other intervertebral disc degeneration, thoracolumbar region
M51.36Other intervertebral disc degeneration, lumbar region
M51.37Other intervertebral disc degeneration, lumbosacral region
M51.44Schmorl's nodes, thoracic region
M51.45Schmorl's nodes, thoracolumbar region
M51.46Schmorl's nodes, lumbar region
M51.47Schmorl's nodes, lumbosacral region
M51.84Other intervertebral disc disorders, thoracic region
M51.85Other intervertebral disc disorders, thoracolumbar region
M51.86Other intervertebral disc disorders, lumbar region
M51.87Other intervertebral disc disorders, lumbosacral region
M51.9Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder
M53.0Cervicocranial syndrome
M53.1Cervicobrachial syndrome
M53.82Other specified dorsopathies, cervical region
M54.10Radiculopathy, site unspecified
M54.11Radiculopathy, occipito-atlanto-axial region
M54.12Radiculopathy, cervical region
M54.13Radiculopathy, cervicothoracic region
M54.14Radiculopathy, thoracic region
M54.15Radiculopathy, thoracolumbar region
M54.16Radiculopathy, lumbar region
M54.17Radiculopathy, lumbosacral region
M54.18Radiculopathy, sacral and sacrococcygeal region
M54.2Cervicalgia
M54.30Sciatica, unspecified side
M54.31Sciatica, right side
M54.32Sciatica, left side
M54.40Lumbago with sciatica, unspecified side
M54.41Lumbago with sciatica, right side
M54.42Lumbago with sciatica, left side
M54.5Low back pain
M54.6Pain in thoracic spine
M54.89Other dorsalgia
M54.9Dorsalgia, unspecified
M60.000Infective myositis, unspecified right arm
M60.001Infective myositis, unspecified left arm
M60.002Infective myositis, unspecified arm
M60.003Infective myositis, unspecified right leg
M60.004Infective myositis, unspecified left leg
M60.005Infective myositis, unspecified leg
M60.009Infective myositis, unspecified site
M60.011Infective myositis, right shoulder
M60.012Infective myositis, left shoulder
M60.019Infective myositis, unspecified shoulder
M60.021Infective myositis, right upper arm
M60.022Infective myositis, left upper arm
M60.029Infective myositis, unspecified upper arm
M60.031Infective myositis, right forearm
M60.032Infective myositis, left forearm
M60.039Infective myositis, unspecified forearm
M60.041Infective myositis, right hand
M60.042Infective myositis, left hand
M60.043Infective myositis, unspecified hand
M60.044Infective myositis, right finger(s)
M60.045Infective myositis, left finger(s)
M60.046Infective myositis, unspecified finger(s)
M60.051Infective myositis, right thigh
M60.052Infective myositis, left thigh
M60.059Infective myositis, unspecified thigh
M60.061Infective myositis, right lower leg
M60.062Infective myositis, left lower leg
M60.069Infective myositis, unspecified lower leg
M60.070Infective myositis, right ankle
M60.071Infective myositis, left ankle
M60.072Infective myositis, unspecified ankle
M60.073Infective myositis, right foot
M60.074Infective myositis, left foot
M60.075Infective myositis, unspecified foot
M60.076Infective myositis, right toe(s)
M60.077Infective myositis, left toe(s)
M60.078Infective myositis, unspecified toe(s)
M60.08Infective myositis, other site
M60.09Infective myositis, multiple sites
M60.80Other myositis, unspecified site
M60.811Other myositis, right shoulder
M60.812Other myositis, left shoulder
M60.819Other myositis, unspecified shoulder
M60.821Other myositis, right upper arm
M60.822Other myositis, left upper arm
M60.829Other myositis, unspecified upper arm
M60.831Other myositis, right forearm
M60.832Other myositis, left forearm
M60.839Other myositis, unspecified forearm
M60.841Other myositis, right hand
M60.842Other myositis, left hand
M60.849Other myositis, unspecified hand
M60.851Other myositis, right thigh
M60.852Other myositis, left thigh
M60.859Other myositis, unspecified thigh
M60.861Other myositis, right lower leg
M60.862Other myositis, left lower leg
M60.869Other myositis, unspecified lower leg
M60.871Other myositis, right ankle and foot
M60.872Other myositis, left ankle and foot
M60.879Other myositis, unspecified ankle and foot
M60.88Other myositis, other site
M60.89Other myositis, multiple sites
M60.9Myositis, unspecified
M62.20Nontraumatic ischemic infarction of muscle, unspecified site
M62.211Nontraumatic ischemic infarction of muscle, right shoulder
M62.212Nontraumatic ischemic infarction of muscle, left shoulder
M62.219Nontraumatic ischemic infarction of muscle, unspecified shoulder
M62.221Nontraumatic ischemic infarction of muscle, right upper arm
M62.222Nontraumatic ischemic infarction of muscle, left upper arm
M62.229Nontraumatic ischemic infarction of muscle, unspecified upper arm
M62.231Nontraumatic ischemic infarction of muscle, right forearm
M62.232Nontraumatic ischemic infarction of muscle, left forearm
M62.239Nontraumatic ischemic infarction of muscle, unspecified forearm
M62.241Nontraumatic ischemic infarction of muscle, right hand
M62.242Nontraumatic ischemic infarction of muscle, left hand
M62.249Nontraumatic ischemic infarction of muscle, unspecified hand
M62.251Nontraumatic ischemic infarction of muscle, right thigh
M62.252Nontraumatic ischemic infarction of muscle, left thigh
M62.259Nontraumatic ischemic infarction of muscle, unspecified thigh
M62.261Nontraumatic ischemic infarction of muscle, right lower leg
M62.262Nontraumatic ischemic infarction of muscle, left lower leg
M62.269Nontraumatic ischemic infarction of muscle, unspecified lower leg
M62.271Nontraumatic ischemic infarction of muscle, right ankle and foot
M62.272Nontraumatic ischemic infarction of muscle, left ankle and foot
M62.279Nontraumatic ischemic infarction of muscle, unspecified ankle and foot
M62.28Nontraumatic ischemic infarction of muscle, other site
M62.40Contracture of muscle, unspecified site
M62.411Contracture of muscle, right shoulder
M62.412Contracture of muscle, left shoulder
M62.419Contracture of muscle, unspecified shoulder
M62.421Contracture of muscle, right upper arm
M62.422Contracture of muscle, left upper arm
M62.429Contracture of muscle, unspecified upper arm
M62.431Contracture of muscle, right forearm
M62.432Contracture of muscle, left forearm
M62.439Contracture of muscle, unspecified forearm
M62.441Contracture of muscle, right hand
M62.442Contracture of muscle, left hand
M62.449Contracture of muscle, unspecified hand
M62.451Contracture of muscle, right thigh
M62.452Contracture of muscle, left thigh
M62.459Contracture of muscle, unspecified thigh
M62.461Contracture of muscle, right lower leg
M62.462Contracture of muscle, left lower leg
M62.469Contracture of muscle, unspecified lower leg
M62.471Contracture of muscle, right ankle and foot
M62.472Contracture of muscle, left ankle and foot
M62.479Contracture of muscle, unspecified ankle and foot
M62.48Contracture of muscle, other site
M62.49Contracture of muscle, multiple sites
M62.50Muscle wasting and atrophy, not elsewhere classified, unspecified site
M62.511Muscle wasting and atrophy, not elsewhere classified, right shoulder
M62.512Muscle wasting and atrophy, not elsewhere classified, left shoulder
M62.519Muscle wasting and atrophy, not elsewhere classified, unspecified shoulder
M62.521Muscle wasting and atrophy, not elsewhere classified, right upper arm
M62.522Muscle wasting and atrophy, not elsewhere classified, left upper arm
M62.529Muscle wasting and atrophy, not elsewhere classified, unspecified upper arm
M62.531Muscle wasting and atrophy, not elsewhere classified, right forearm
M62.532Muscle wasting and atrophy, not elsewhere classified, left forearm
M62.539Muscle wasting and atrophy, not elsewhere classified, unspecified forearm
M62.541Muscle wasting and atrophy, not elsewhere classified, right hand
M62.542Muscle wasting and atrophy, not elsewhere classified, left hand
M62.549Muscle wasting and atrophy, not elsewhere classified, unspecified hand
M62.551Muscle wasting and atrophy, not elsewhere classified, right thigh
M62.552Muscle wasting and atrophy, not elsewhere classified, left thigh
M62.559Muscle wasting and atrophy, not elsewhere classified, unspecified thigh
M62.561Muscle wasting and atrophy, not elsewhere classified, right lower leg
M62.562Muscle wasting and atrophy, not elsewhere classified, left lower leg
M62.569Muscle wasting and atrophy, not elsewhere classified, unspecified lower leg
M62.571Muscle wasting and atrophy, not elsewhere classified, right ankle and foot
M62.572Muscle wasting and atrophy, not elsewhere classified, left ankle and foot
M62.579Muscle wasting and atrophy, not elsewhere classified, unspecified ankle and foot
M62.58Muscle wasting and atrophy, not elsewhere classified, other site
M62.59Muscle wasting and atrophy, not elsewhere classified, multiple sites
M62.81Muscle weakness (generalized)
M62.82Rhabdomyolysis
M62.831Muscle spasm of calf

Version Effective Date: 10/01/2019
Version Issued Date: 10/02/2019
Version Reissued Date: 11/20/2019



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