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I wanted to find out if when testing a patient for sleep appliance therapy can we bill out other services other than an exam. For example... code 95851 for range of motion testing or code 95831 for Manual muscle testing?
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Hi stratforddental!
Great question. The short answer is yes! You can always attempt to bill out procedures performed in your office if they are part of your medical treatment.
Now the longer answer - depending on what it is, the insurer may or may not consider it a medically necessary diagnostic/evaluation procedure! For example, some insurers are starting to deny CT scans (70486) as not a medically necessary part of oral appliance therapy for OSA, and will not pay for them if the diagnosis is 327.23.
So as for the two codes you listed:
(95851) - range of motion measurements & report, extremity or trunk only
(95831) - muscle testing, manual, extremity or trunk only
Both of these codes specify in the description they are for extremity or trunk only.
Many times range of motion testing will be considered part of the reimbursement you receive for an evaluation & management code billed for that visit (your office visit codes)
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