NCD 160.26

Item/Service Description

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.

Indications and Limitations of Coverage

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.)

Revision History

11/2006 -Is not reasonable and necessary for Medicare beneficiaries undergoing nerve-sparing prostatic or colorectal surgical procedures. Effective date 8/24/2006. Implementation date 01/08/2007. (TN 61) (CR 5294)