Neurology & Pain Management Coding Alert

Question: How should I bill Medicare for sNCT?

Utah Subscriber

Answer: Medicare has created a special G code to report current perception/sensory nerve conduction threshold testing (sNCT): G0255 (Current perception threshold/sensory nerve conduction test, [sNCT] per limb, any nerve). The test is noninvasive, using a transcutaneous electrical stimulus to evoke a sensation to diagnose various sensory neuropathies. But Medicare (Program Memorandum AB-02-066, Change Request 2153, May 2, 2002) has "determined that there is insufficient scientific or clinical evidence to consider the use of this device as reasonable and necessary and, therefore, Medicare will not pay for this type of test."

Do not use 95904 (Nerve conduction, amplitude and latency/velocity study, each nerve; sensory) when reporting sNCT for Medicare. As Noridian, a Medicare Part B payer in Alaska, Arizona, Colorado, Hawaii, Iowa, Nevada, North Dakota, Oregon, South Dakota, Washington and Wyoming, makes clear in its local medical review policy (LMRP), "the use of code 95904 is inappropriate for this test, as it does not describe the test being performed. Use of this code could warrant a review of medical records and a potential fraud referral."