Listing New York S04

Nerve Conduction Studies. Number 0. 50. 2Policy. Aetna considers nerve conduction velocity NCV studies medically necessary when both of the following criteria are met Member has any of the following indications Diagnosis and prognosis of traumatic nerve lesions e. Listing New York S04' title='Listing New York S04' />Diagnosis and monitoring of neuromuscular junction disorders e. Diagnosis of muscle disorders e. Diagnosis or confirmation of suspected generalized neuropathies including uremic, metabolic or immune e. Guillain Barr Syndrome, muscular dystrophy, post polio syndrome or. Differential diagnosis of physical examination findings of sensory loss, weakness andor muscle atrophy with no known etiology e. Differential diagnosis of symptom based complaints e. Localization of focal neuropathies or compressive lesions e. Bells palsy of the facial nerve, carpal tunnel syndrome see selection criteria below, tarsal tunnel syndrome, nerve root compression, neuritis, motor neuropathy, mononeuropathy, radiculopathy see selection criteria below, plexopathy or. Peripheral neuropathy  unexplained peripheral neuropathy with pain of a neuropathic pattern, and with demonstrated motor loss or sensory loss, all of unknown etiology and. The member has had a needle electromyographic EMG study to evaluate the condition either concurrently or within the past year. The requirement for needle EMG with NCV may be waived for persons on anti coagulant therapy with warfarin Coumadin, direct thrombin inhibitors e. Pradaxa, desirudin Iprivask, or heparins that can not be interrupted. It may also be waived when the purpose of the NCV study is solely to diagnose or rule out one of the following carpal tunnel syndrome, Charcot Marie Tooth disease,myasthenia gravis or Lambert Eaton myasthenic syndrome. Aetna considers NCV studies experimental and investigational when these criteria are not met. Carpal Tunnel Syndrome Selection Criteria For evaluation of individuals suspected of having carpal tunnel syndrome, Aetna considers the following services to be medically necessary Sensory conduction studies across the wrist of the median nerve, and if the results are abnormal, of one other sensory nerve in the symptomatic limb and. If the initial median sensory nerve conduction study across the wrist has a conduction distance greater than 8 cm, and the results are normal, additional studies as listed below Comparison of median sensory conduction across the wrist with radial or ulnar sensory conduction across the wrist in the same limb or. Median sensory conduction across the wrist over a short 7 to 8 cm conduction distance. Motor conduction studies of the median nerve recording from the thenar muscle and of one other nerve in the symptomatic limb to include measurement of distal latency. Cervical, Thoracic or Lumbar Radiculopathy Selection Criteria NCVs are considered medically necessary for evaluation of cervical, thoracic or lumbar radiculopathy when all of the following criteria are met Persistent or progressive symptoms and. Failed conservative treatment eg, medications, physical therapy, etc. Listing New York S04 Yeast' title='Listing New York S04 Yeast' />Unexplained by imaging studies eg, magnetic resonance imaging MRI, myelogram, etc. Diabetic Peripheral Neuropathy Criteria NCVs are considered medically necessary for persons with diabetes who have persistent or progressive symptoms of neuropathy despite conservative treatments e. NCVs are considered experimental and investigational for screening for diabetic neuropathy and for monitoring disease intensity and response to treatment. Frequency of Testing. The following table lists the American Association of Neuromuscular Electrodiagnostic Medicines formerly known as American Association of Electrodiagnostic Medicine recommendations concerning a reasonable maximum number of NCV, needle EMG and other EMG studies per diagnostic category needed for a physician to render a diagnosis Note This table provides the medically necessary maximal number of nerve conduction studies it does NOT imply that an F wave study is necessary for carpal tunnel syndrome. Nerve Conduction Studies. Other EMG Studies  Indications. Needle EMGMotor NCV studies with andor without Fwave Sensory NCV studies. H Reflex. Neuromuscular Junction Testing Repetitive StimulationCarpal tunnel unilateral1. Carpal tunnel bilateral2. Radiculopathy. 23. Mononeuropathy. 13. PolyneuropathyMononeuropathy Multiplex. Myopathy. 22. 2 2. Motor Neuropathy. Plexopathy. 24. 62 Neuromuscular junction. Listing New York S04 2Federal government web portal for veteran owned businesses. Supports the implementation of the Veterans Entrepreneurship and Small Business Development Act of 1999. Summary Tables and percent relative standard errors. The percent relative standard errors in tables A1 and A2 are a measure of sampling error, one of the measures of. Watch full episodes of all the best TV shows online. Listing New York S042Tarsal tunnel syndrome unilateral1. Tarsal tunnel syndrome bilateral2. Weakness, fatigue, cramps, or twitching focal2. B8N_&timestamp=1434570865' alt='Listing New York S04e05' title='Listing New York S04e05' />Weakness, fatigue, cramps, or twitching general4. Pain, numbness, or tingling unilateral1. Pain, numbness, or tingling bilateral2. Source AMA, 2. 01. Utilization of motor or sensory nerve conduction velocity studies at a frequency of 2 sessions per year would be considered appropriate for most conditions e. Nerve conduction velocity studies performed more frequently than twice a year may be reviewed for medical necessity. F waves and H reflex studies are performed to evaluate nerve conduction in portions of the nerve more proximal near the spine and, therefore, inaccessible to direct assessment using conventional techniques. Electrical stimulation is applied on the skin surface near a nerve site in a manner that sends impulses both proximally and distally. Characteristics of the response are assessed, including latency. Late responses provide information in the evaluation of radiculopathies, plexopathies, polyneuropathies especially with multifocal conduction block or in suspected Guillain Barr syndrome or chronic inflammatory demyelinating polyneuropathy, and proximal mononeuropathies. In some cases, they may be the only abnormal study. Free Dvd Ripping Software For Encrypted Dvds. Motor and sensory NCV studies and late responses F waves and H reflex studies are often complementary and performed during the same evaluation. Listing New York S04' title='Listing New York S04' />H Reflex Studies Typically, only 2 H reflex studies are performed in a given examination. H reflex studies usually must be performed bilaterally because symmetry of responses is an important criterion for abnormality. When a bilateral H reflex study is performed, the entire procedure must be repeated, increasing examiner time and effort there are no economies of scale in multiple H reflex testing. H reflex studies usually involve assessment of the gastrocnemiussoleus muscle complex in the calf. Bilateral gastrocnemiussoleus H reflex abnormalities are often early indications of spinal stenosis, or bilateral S1 radiculopathies. In rare instances, H reflexes need to be tested in muscles other than the gastrocnemiussoleus muscle, e. In conditions such as cervical radiculopathies or brachial plexopathies, an H reflex study can be performed in the arm flexor carpi radialis muscle. Other muscles that may be tested, although rarely, are the intrinsic small muscles of the hand and foot. F Wave Studies Although the set up for an F wave study is similar to the set up for a motor NCV study, the testing is carried out separately from motor NCV study, utilizing different machine settings and separate stimulation to obtain a larger number of responses at least 1.