Neurotron, Incorporated

   Innovative Medical Technology

                 Established 1981

Neurometer^® sNCT Electrodiagnostic Evaluation

Government, Insurance, Associations, Institutions
and Legal Evaluations/Citations

Government
	Commonwealth of Massachusetts
	Commonwealth of Pennsylvania
	State of Texas
	State of Washington
	Japan
	South Korea
	China
Insurance
	Allstate Insurance Company
	Nationwide Insurance Company
	Principal Life Insurance Company
Association (Review articles are available at this link)
	American Academy of Clinical Endocrinologists
	The National Guideline Clearinghouse™ (USA)
	American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM)
	American Clinical Neurophysiology Society
Institutional Involvement (pdf document download)
Legal Citations
Additional information is available upon request

 

 

Government

 

Commonwealth of Massachusetts

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.

 

Commonwealth of Pennsylvania

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.

 

 

State of Texas

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.

 

Washington State
On March 1,1999, Industrial Appeals Judge Kathryn Guykema, of the Board of Industrial Insurance Appeals, State of Washington, concluded in a hearing related to the utility of the Neurometer^® sNCT^®/CPT^® electrodiagnostic evaluation of Carpal Tunnel Syndrome: “The CPT Neurometer provides proper and necessary medical services within the meaning of RCW 51.36.010 and it was not improper to bill using procedure code 95904 ”...“and that providers are not precluded from submitting billings for diagnostic testing using the CPT Neurometer”. (Docket No. 98 P0056)

 

Japan

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.

 

South Korea

The citizens of South Korea have universal health coverage that since 1998 has reimbursed for Neurometer^® sNCT^® diagnostic evaluations. 

 

China

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.

 

top of page      Previous page     Home

 

 

 

Insurance  (USA - Billing Code Information)

 

Allstate insurance Company
On April 3, 1995 at the US District Court, Eastern District of New York, Mario Introna vs. Allstate Insurance Company, 93-CV-2870, Judge Bartels, based upon recommendations by the expert from the Allstate Insurance Company, determined that the correct procedure code to be utilized for the sensory Nerve Conduction Threshold (sNCT®) electrodiagnostic evaluation Current Perception Threshold (CPT) evaluation be the same code that is used for the sensory nerve conduction velocity evaluation - 95904.
 

Nationwide Insurance Company
In January 1998, Nationwide Insurance Company reported that the sNCT®/CPT evaluation "proved to have clinical applications. Independent neurologists contacted stated CPT was a reimbursable procedure. These opinions, and discussion with area physicians on the effectiveness if a CPT evaluation in their practices resulted in the reimbursement of the CPT procedure"..."With the 1997 coding revisions, CPT is being submitted under the 95904 procedure code."

Principal Life Insurance Company
The Principal Life Insurance Company and their outside consultant, a board certified Neurologist, conducted an evaluation of the sensory Nerve Conduction Threshold (sNCT®) procedure and determined that it was a covered procedure according to letter of Aug. 21, 2002.

 

 

 

Associations

 

American Academy of Clinical Endocrinologists (AACE)
In November. 2001, and October 2009. the AACE conducted comprehensive scientific reviews to date of the sNCT^® evaluation of diabetic neuropathy of any medical professional association and submitted its findings to the Unites States Centers for Medicare & Medicaid Services (CMS) in support of the clinical use of the sNCT^® evaluation as being considered, “reasonable and necessary for the Medicare population".

 

The National Guideline Clearinghouse™ (USA)
The is documentation of an independent scientific body confirming the utility of the sNCT and documenting dysfunction of the sensory nerves.  “The National Guideline Clearinghouse™ (NGC) is a comprehensive database of evidence-based clinical practice guidelines and related documents. NGC is an initiative of the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services. NGC was originally created by AHRQ in partnership with the American Medical Association and the American Association of Health Plans (now America's Health Insurance Plans [AHIP]).  The NGC mission is to provide physicians, nurses, and other health professionals, health care providers, health plans, integrated delivery systems, purchasers and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation and use.”

The NGC provides the following guidelines with respect to the Current Perception Threshold (CPT) electrodiagnostic evaluation, dated July, 2005:

“Current Perception Threshold (CPT) Testing
Sub-Recommendation

Current perception threshold devices may be used for the quantitative assessment of sensory nerve function. Alterations in sensory nerve function may be associated with vertebral subluxation.

Rating: Established

Evidence: E, L

Categories of Evidence:

E: Expert opinion based on clinical experience, basic science rationale, and/or individual case studies. Where appropriate, this category includes legal opinions.

L: Literature support in the form of reliability and validity studies, observational studies, "pre-post" studies, and/or multiple case studies. Where appropriate, this category includes case law.”

 

American Clinical Neurophysiology Society

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 highly favorable.
 

 

 

Legal Citations

The following list provides examples of legal citations:

1. Herman Leblanc, Jr. vs Aetna Life and Casualty Co., OWC#90-01163, District 5

2. Kenneth Atkinson vs Ethyl Corporation, et. al., District Court of Harris County Texas, 152nd Judicial District.

3. Lilburn Levay Fuller and Gary James Darby vs Union Equity Cooperative Exchange, et. al.

4. Lilburn Levay Fuller vs Gulf Stream Maritime and Aetna Casualty and Surety Co., OWC #8-91011.

5. Gary James Darby vs Gulf Stream Maritime and Aetna Casualty and Surety Co., OWC #8-91032.

6. Ruth Theirry Bird vs Jimmy D. Qualle and Jonathon Kaizer. Okmulgee District Court, Okmulgee, Oklahoma.

7. Jack L. Pope vs Hinz Trucking-a foreign corporation & Allan Zuckert-an individual, Okmulgee District Court, Okmulgee, Oklahoma.

8. Stacy Null vs Ruben Gomez Superior Court for the County of Ventura, California, Case #123736 (1/31/94).

9. GTE vs. Wilson-Briton, before the State of Washington Board of Industrial Insurance Appeals, Claim T579020 Docket #924082. Proposed decision and order, re: Judith M. Wilson, July 15, 1993.

10. Onamura vs Weisman, Case No.92-3169-09, Circuit Court of the First Circuit of the State of Hawaii, Honolulu, August, 1995.

11. Louise Jones vs Nationwide Ins. Co. / Solomon, Docket 64834-6 T.D., Shelby County, TN. Circuit Court, October, 1997.

12. Havsy, S.L., D.O. and Pain Diagnostics and Rehabilitation Associates, P.S., Before the Board of Industrial Insurance Appeals State of Washington, Docket No. 98.P0056, Provider No. 55001 & 56000, Industrial Appeals Judge: Kathryn Guykema, March 1999.

13. Christopher Dial and Angeline Taylor v. Grave Rigsby, Order CCG-N002, IL, 97 M4 704, Fourth Municipal District Circuit Court of Cook County, Judge James V. Murphy, May 24, 2000. Aurelia Pucinski, Clerk of the Circuit Court.