CMS Pub. 100-03, ch. 1, § 160.23

April 1, 2004)

(Rev. 15, 06-18-04)

A. General

The sNCT is a psychophysical assessment of both central and peripheral nerve functions.

It measures the detection threshold of accurately calibrated sensory stimuli. This

procedure is intended to evaluate and quantify function in both large and small caliber

fibers for the purpose of detecting neurologic disease. Sensory perception and threshold

detection are dependent on the integrity of both the peripheral sensory apparatus and

peripheral-central sensory pathways. In theory, an abnormality detected by this

procedure may signal dysfunction anywhere in the sensory pathway from the receptors,

the sensory tracts, the primary sensory cortex, to the association cortex.

This procedure is different and distinct from assessment of nerve conduction velocity,

amplitude and latency. It is also different from short-latency somatosensory evoked

potentials.

Effective October 1, 2002, CMS initially concluded that there was insufficient scientific

or clinical evidence to consider the sNCT test and the device used in performing this test

reasonable and necessary within the meaning of section 1862(a)(1)(A) of the law.

Therefore, sNCT was noncovered.

Effective April 1, 2004, based on a reconsideration of current Medicare policy for sNCT,

CMS concludes that the use of any type of sNCT device (e.g., “current output” type

device used to perform current perception threshold (CPT), pain perception threshold

(PPT), or pain tolerance threshold (PTT) testing or “voltage input” type device used for

voltage-nerve conduction threshold (v-NCT) testing) to diagnose sensory neuropathies or

radiculopathies in Medicare beneficiaries is not reasonable and necessary.

B. Nationally Covered Indications

Not applicable.

C. Nationally Noncovered Indications

All uses of sNCT to diagnose sensory neuropathies or radiculopathies are noncovered.

(This NCD last reviewed June 2004.)