NCD 160.23

Item/Service Description

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.

Indications and Limitations of Coverage

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.)

Revision History

06/2004 - Reaffirmed existing Medicare noncoverage policy on any type of Sensory Nerve Conduction Threshold (sNCT) Test, and device used to perform test, to diagnose sensory neuropathies or radiculopathies. Recinds and replaces TN 8. Effective and implementation dates 04/01/2004. (TN 15) (CR 3339)

03/2004 - Reaffired existing Medicare noncoverage policy on Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT). Effective and implementation dates 04/01/2004. (TN 8) (CR 2988)

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)