Neurology & Pain Management Coding Alert

Question: How should we report current perception threshold testing? The machine manufacturer recommends reporting 95904, but we've been receiving denials.

Illinois Subscriber

Answer: You should definitely not use 95904 (Nerve conduction, amplitude and latency/velocity study, each nerve; sensory) to report current perception threshold testing, also called sensory nerve conduction threshold test (sNCT). Instead, you must turn to HCPCS code G0255 (Current perception threshold/sensory nerve conduction test [SNCT], per limb, any nerve) to describe the test.
 
Current perception threshold testing/sNCT is a non-covered service for Medicare payers, as well as most private payers. Therefore, you should not expect payment from Medicare for this type of testing.
 
If you plan to offer patients this service, you should alert them before testing that Medicare will not pay for the procedure and, therefore, the patient himself will be responsible for payment. Because Medicare has designated it a "noncovered" procedure, however, you don't need to ask patients to sign an advance beneficiary notice to collect payment from them.
 
For more information on Medicare's position on sNCT, visit the CMS Web site at http://www.cms.hhs.gov/medlearn/matters/mmarticles/2004/MM2988.pdf.