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National Coverage Determination (NCD)

Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT) NonCovered

50-57

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Tracking Information

Publication Number
6
Manual Section Number
50-57
Manual Section Title
Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT) NonCovered
Version Number
1
Effective Date of this Version
10/01/2002
Ending Effective Date of this Version
04/01/2004
Implementation Date
10/01/2002
Implementation QR Modifier Date

Description Information

Benefit Category
Diagnostic Tests (other)


Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Item/Service Description

The Current Perception Threshold/Sensory Nerve Conduction Threshold (sNCT) test is a diagnostic test used to diagnose sensory neuropathies. The device is a noninvasive test that uses transcutaneous electrical stimuli to evoke a sensation.
Indications and Limitations of Coverage

There is insufficient scientific or clinical evidence to consider this device reasonable and necessary within the meaning of Section 1862(a)(1)(A) of the law and will not be covered by Medicare.
Cross Reference
Claims Processing Instructions

Transmittal Information

Transmittal Number
156
Coverage Transmittal Link
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R156CIM.pdf
Revision History

05/2002 - Provided that there is insufficient scientific or clinical evidence to consider this device as reasonable and necessary within the meaning of §1862(a)(1)(A) of the Social Security Act and will not be covered by Medicare. Also, established a new code G0255 for this test. The code descriptor is Current Perception Threshold/Sensory Nerve Conduction Threshold test (sNCT), per limb, any nerve - (Not covered by Medicare). Effective and implementation dates 07/01/2002. (TN 156) (CR 2153)
Other

National Coverage Analyses (NCAs)

This NCD has been or is currently being reviewed under the National Coverage Determination process. The following are existing associations with NCAs, from the National Coverage Analyses database.

Coding Analyses for Labs (CALs)

This NCD has been or is currently being reviewed under the National Coverage Determination process. The following are existing associations with CALs, from the Coding Analyses for Labs database.

Additional Information

Other Versions
Title Version Effective Between
Sensory Nerve Conduction Threshold Tests (sNCTs) 2 04/01/2004 - N/A View
Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT) NonCovered 1 10/01/2002 - 04/01/2004 You are here
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Reasons for Denial
Note: This section has not been negotiated by the Negotiated RuleMaking Committee. It includes CMS’s interpretation of it’s longstanding policies and is included for informational purposes. Tests for screening purposes that are performed in the absense of signs, symptoms, complaints, or personal history of disease or injury are not covered except as explicity authorized by statue. These include exams required by insurance companies, business establishments, government agencies, or other third parties. Tests that are not reasonable and necessary for the diagnosis or treatment of an illness or injury are not covered according to the statue. Failure to provide documentation of the medical necessity of tests may result in denial of claims. The documentation may include notes documenting relevant signs, symptoms, or abnormal findings that substantiate the medical necessity for ordering the tests. In addition, failure to provide independent verification that the test was ordered by the treating physician (or qualified nonphysician practitioner) through documentation in the physician’s office may result in denial. A claim for a test for which there is a national coverage or local medical review policy will be denied as not reasonable and necessary if it is submitted without an ICD-9-CM code or narrative diagnosis listed as covered in the policy unless other medical documentation justifying the necessity is submitted with the claim. If a national or local policy identifies a frequency expectation, a claim for a test that exceeds that expectation may be denied as not reasonable and necessary, unless it is submitted with documentation justifying increased frequency. Tests that are not ordered by a treating physician or other qualified treating nonphysician practitioner acting within the scope of their license and in compliance with Medicare requirements will be denied as not reasonable and necessary. Failure of the laboratory performing the test to have the appropriate Clinical Laboratory Improvement Act of 1988 (CLIA) certificate for the testing performed will result in denial of claims.
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