LCD/NCD Portal

NCD160.23 SENSORY NERVE CONDUCTION THRESHOLD TESTS (SNCTS)

 

 

Effective Date of this Version

• 4/1/2004

 

 

Benefit Category

 

• Diagnostic X-Ray Tests.

• Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

 

 

Item/Service Description

 

A. General

• The sNCT is a psychophysical assessment of both central and peripheral nerve functions.

o It measures the detection threshold of accurately calibrated sensory stimuli.

o This procedure is intended to evaluate and quantify function in both large and small caliber fibers for the purpose of detecting neurologic disease.

o Sensory perception and threshold detection are dependent on the integrity of both the peripheral sensory apparatus and peripheral-central sensory pathways.

o In theory, an abnormality detected by this procedure may signal dysfunction anywhere in the sensory pathway from the receptors, the sensory tracts, the primary sensory cortex, to the association cortex.

• This procedure is different and distinct from assessment of nerve conduction velocity, amplitude and latency.

o It is also different from short-latency somatosensory evoked potentials.

• Effective October 1, 2002, CMS initially concluded that there was insufficient scientific or clinical evidence to consider the sNCT test and the device used in performing this test reasonable and necessary within the meaning of section 1862(a)(1)(A) of the law.

o Therefore, sNCT was noncovered.

• Effective April 1, 2004, based on a reconsideration of current Medicare policy for sNCT, CMS concludes that the use of any type of sNCT device (e.g., “current output” type device used to perform current perception threshold (CPT), pain perception threshold (PPT), or pain tolerance threshold (PTT) testing or “voltage input” type device used for voltage-nerve conduction threshold (v-NCT) testing) to diagnose sensory neuropathies or radiculopathies in Medicare beneficiaries is not reasonable and necessary.

 

 

Indications and Limitations of Coverage

 

Nationally Covered Indications

 

• Not applicable.

 

 

Nationally Noncovered Indications

 

• All uses of sNCT to diagnose sensory neuropathies or radiculopathies are noncovered.

• (This NCD last reviewed June 2004.)

 

 

Coverage Transmittal Link

 

• http://www.cms.gov/transmittals/downloads/R15NCD.pdf

 

 

National Coverage Analyses (NCAs)

 

• This NCD has been or is currently being reviewed under the National Coverage Determination process.

• The following are existing associations with NCAs, from the National Coverage Analyses database.

o Original consideration for Electrodiagnostic Sensory Nerve Conduction Threshold (CAG-00106N)

o First reconsideration for Electrodiagnostic Sensory Nerve Conduction Threshold (CAG-00106R)

 

Medicare NCD Link