Neurology & Pain Management Coding Alert

Neurology practices that use sensory nerve conduction threshold testing (sNCT) to diagnose conditions such as carpal tunnel syndrome (354.0) should be aware that CMS issued a national noncoverage decision for this test. CMS transmittal AB-02-066, released May 2, 2002, states, "insufficient scientific or clinical evidence" exists to consider the test reasonable and necessary. This decision is effective for dates of service on or after Oct. 1, 2002.

Neurologists who perform sNCT (which uses a combination of nerve conduction study and TENS techniques) have been using 95904 (Nerve conduction, amplitude and latency/velocity study, each nerve; sensory), 95925 (Short-latency somatosensory evoked potential study, stimulation of an/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs) or 95999 (Unlisted neurological or neuromuscular diagnostic procedure) to bill for it. Beginning Oct. 1, neurologists should no longer bill Medicare for sNCT, although some private payers may still cover it. Note that the standard nerve conduction study tests described in CPT 2002 by codes 95900-95904 are still covered as before.

Although the new HCPCS code G0255 (Current perception threshold/sensory nerve conduction threshold test [sNCT], per limb, any nerve) was recently established to denote use of the sNCT test, introduction of the code in no way means that the test is payable. Medicare will deny G0255 beginning Oct. 1.