Innovative Medical Technology
Neurometer® sNCT Electrodiagnostic Evaluation
Government, Insurance, Associations, Institutionsand Legal Evaluations/Citations
On April 10, 2002, The Commonwealth of Massachusetts, Department of Industrial Accidents, Administrative Judge James L. Lamothe Jr. ruled that the Argonaut Insurance Company acting upon a claim processed by CONCENTRA Managed Care Services, Inc., an accredited Utilization-Review Accreditation Commission, also known as the American Accreditation Health Care Commission, must reimburse for the neuroselective sensory Nerve Conduction Threshold (sNCT®) electrodiagnostic evaluation with Current Perception Threshold (CPT®) measures. The Order specifically states “The Insurer shall pay for the CPT test.” A determination was made that the sNCT®/CPT evaluation was reasonable and necessary. The physician requested the sNCT®/CPT evaluation because the MRI and EMG evaluations although both negative are insensitive to small fiber sensory nerve impairments capable of causing the patients pain that may be detected and evaluated by the sNCT®/CPT measures.
There was formal recognition of the clinical utility of the by the Commonwealth of Pennsylvania, Department of State, Bureau of Professional and Occupational Affairs, State Boards of Physical Therapy and Occupational Therapy, 1990.
The State of Texas Workers' Compensation Commission (TWCC) during development of the Spine Treatment Guideline (STG) effective February 1, 2000, had it's Medical Review Division established a Spine Treatment Guideline Revision Workgroup (STGRRW) composed of healthcare providers from 10 different specialty fields and representatives from the health insurance industry. Extensive reviews were performed of pertinent literature, published studies and issues submitted by public cementers. The committee and staff review concluded that the sNCT evaluation was effective for testing for peripheral neuropathy and was an appropriate diagnostic tool for the quantitative measure of the functional integrity of sensory nerve fibers. The results of this review were included in the Preamble of the amendments to the STG, published in the Texas Register. "As a nerve conduction study, CPT was deemed to be an appropriate diagnostic tool and was included in the List of Diagnostic Interventions", according to Mr. Tom Hardy, Director, Medical Review Division Director, TWCC. This December 17, 1999, Texas Register, page 7, states it, "supported the efficacy for CPT testing for peripheral neuropathy that it's not clinically detectable through sensory nerve conduction velocity (NCV) studies. Staff's review of the literature also supported the efficacy of CPT® testing for the evaluation of radiculopathies and as an appropriate diagnostic tool for the quantitative measure of the functional integrity of sensory nerve fibers. CPT® is considered a NCS (nerve conduction study), and is therefore included in the STG". The State of Texas Workers’ Compensation Commission discusses how the Neurometer CPT evaluation should be billed under "EMG/nerve conduction studies" (Note pages 7, 10 and 14 Subsection (f)(2)(K)). The AMA CPT code for the sensory nerve conduction study is 95904. The Neurometer CPT evaluation is also cited in several of the references beginning on page 51 of this document.
The Japanese government, Ministry of Health, has authorized the insurance reimbursement for the automated neuroselective sNCT® diagnostic evaluation since 1998. The reimbursement rate for this electrodiagnostic evaluation is the same as for the sensory nerve conduction velocity (NCV) procedure.
The citizens of South Korea have universal health coverage that since 1998 has reimbursed for Neurometer® sNCT® diagnostic evaluations.
The Chinese government has granted preliminary approval for coverage of sensory nerve evaluation using the Neurometer® sNCT® diagnostic evaluations. Confirming studies in progress at major hospitals and institutions across China are expected to be completed in 2015.
(USA - Billing Code Information)
Allstate insurance Company
Nationwide Insurance Company
Academy of Clinical Endocrinologists (AACE)
The National Guideline
This society, formerly the
American Encephalographic Society, conducted a
technology review of the Neurometer®
sNCT CPT electrodiagnostic evaluation in 1995.
Routine clinical use was reviewed by clinicians from Creighton University
(>10 years), Harvard Medical School (>5 years), Veterans Administration
Medical Center, New Orleans (>6 years), Internal Medicine Practice,
Layfayette, LA (>3 yrs), Neurology Practice, Ventura, CA (>8 yrs),
University of California, Los Angeles (>5 yrs). All the reviews were
The following list provides examples of legal citations:
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