The EMG report can be a quick rundown of electrical data. Or it can be an important tool for the neuromuscular specialist—a valuable resource for the referring physician, a path to treatment for the patient, and an excellent marketing tool for the specialists themselves. When referring physicians know a specialist will consistently provide thoughtful and useful input via their reports, they will be driven to use that specialist over and over again.
This was the topic of one session at the 2017 meeting of the American Association of Neuromuscular and Electrodiagnostic Medicine, and this post wraps up our three-part series on crafting an EMG report. The AANEM session began with Dr. Devon Rubin discussing the approach to including clinical information in the EMG report, followed by Dr. Elizabeth Mauricio presenting data on using widely understood language to increase the utility of EMG reports.
The session on EMG reports was then rounded out by Kerry Levin, MD, Chair of the Department of Neurology at the Cleveland Clinic. He discussed the specific contents of the EMG report for the dual purposes of utility and reimbursement.
Start with the Basics
The first thing you need to include in your report are the aspects that will help you get paid—the regulatory billing requirements.
This introductory component includes the basic patient data:
- Patient name
- Date of study
- Appropriate identifiers (not the Social Security Number)
It will also include an overview of the report. You want to point out the reasons for the study and an itemized list of studies performed. Finally, include a brief diagnosis or impression.
Once the overview is provided, Levin likes to include limitations of the study and special circumstances that might impact the results. For example, was the test performed bedside or under sedation in the OR? Was it limited by incomplete motor unit activation due to pain or reduced effort? Was there some other factor that may have affected the results in some way? He positions this information near the beginning of the EMG report because “these things form a context” for interpreting the results.
Summarize with Tables
Levin uses tables to report a summary of studies done. He explains that a narrative description is too wordy, making it more difficult for referrers to absorb and take away key information.
Finally, the Results
Once the background, limitations, and summary of studies is provided, it’s finally time to provide a description of abnormalities found. Include location, physiology (such as axon loss or demyelination), activity, chronicity, and severity. If this sounds familiar, it might be because these descriptors were the focus of Mauricio’s information on clear language, which was discussed in Part 2 of this series. Be sure to use standardized language to convey your information in a manner that is as clear as possible.
Give Your Impression
Wrap up the EMG report with a diagnostic impression. As was discussed in Part 1 of this series, Rubin explained that this impression assists referring physicians who may have limited experience with neuromuscular disorders. It may also provide a quicker path to treatment for the patient. However, an EMG is not a complete neurology consult so it is important to consider the medical-legal ramifications of your words.
A well-crafted EMG report is an opportunity for the neuromuscular specialist to provide value for referrers. It creates a path to diagnosis and treatment for patients. It helps ensure reimbursement for work performed. Finally, it helps the specialists establish themselves as a valuable resource for referring physicians—one they will want to turn to again and again for useful, accurate information.
This concludes the three-part recap of the session, EMG Reports: Issues of Report Formulation and Conveying Interpretation to Referring Physicians from the 2017 meeting of the American Association of Neuromuscular and Electrodiagnostic Medicine. Part 1, Creating an EMG Report to Benefit Your Referrers, and Part 2, Do Referring Physicians Understand Your EMG Reports? were published previously on Neurology Insights.