CMS Pub. 100-03, ch. 1, § 160.26

Plethysmography - Effective August 24, 2006

(Rev.61, Issued: 11-24-06, Effective: 08-24-06, Implementation: 01-08-07)

A. General

In nerve-sparing prostatic and colorectal surgical procedures, the assessment of the

function of the cavernous nerves by direct application of electrical stimulation with penile

plethysmography is a diagnostic test, also referred to as cavernosal nerve mapping, which

may be performed to assess the integrity of the cavernous nerves. Through an open or

laparoscopic procedure, the surgeon may want to assess the function of the cavernous

nerves by stimulating the most distal end of the nerve that can be located by using an

electrical nerve stimulator. The presence of a response and the degree of the response

may be used to provide the surgeon with a more realistic assessment of the chance of the

patient regaining potency and assist in choosing appropriate therapy.

B. Nationally Covered Indications

Not applicable.

C. Nationally Non-Covered Indications

Effective August 24, 2006, Cavernous Nerves Electrical Stimulation with penile

plethysmography is non-covered under Medicare. CMS reviewed the evidence and

determined that this test is not reasonable and necessary for Medicare beneficiaries

undergoing nerve-sparing prostatic or colorectal surgical procedures.

D. Other

Also see §20.14, Plethysmograthy.

(This NCD last reviewed September 2006.)