LCD/NCD Portal

NCD160.26 CAVERNOUS NERVES BY ELECTRICAL STIMULATION WITH

PENILE PLETHSMOGRAPHY

 

 

Effective Date of this Version

• 1/2/2007

 

 

Benefit Category

 

• Diagnostic Tests (other).

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

 

 

Item/Service Description

 

 

General

 

• In nerve-sparing prostatic and colorectal surgical procedures, the assessment of the function of the cavernous nerves by direct application of electrical stimulation with penile plethysmography is a diagnostic test, also referred to as cavernosal nerve mapping, which may be performed to assess the integrity of the cavernous nerves.

• Through an open or laparoscopic procedure, the surgeon may want to assess the function of the cavernous nerves by stimulating the most distal end of the nerve that can be located by using an electrical nerve stimulator.

• The presence of a response and the degree of the response may be used to provide the surgeon with a more realistic assessment of the chance of the patient regaining potency and assist in choosing appropriate therapy.

 

 

Indications and Limitations of Coverage

 

Nationally Covered Indications

 

• Not applicable.

 

 

Nationally Non-Covered Indications

 

• Effective August 24, 2006, Cavernous Nerves Electrical Stimulation with penile plethysmography is NON-COVERED under Medicare. CMS reviewed the evidence and determined that this test is NOT reasonable and necessary for Medicare beneficiaries undergoing nerve-sparing prostatic or colorectal surgical procedures.

 

 

Other

 

• Also see §20.14, Plethysmograthy.

• (This NCD last reviewed September 2006.)

 

 

Transmittal Information

 

Coverage Transmittal Link

 

• http://www.cms.gov/transmittals/downloads/R61NCD.pdf

National Coverage Analyses (NCAs)

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.

• Original consideration for Cavernous Nerves Electrical Stimulation with Penile Plethysmography (CAG-00311N)

 

Medicare NCD Link