Highmark blue cross muscle nerve study during surgery

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723 baxter street athens ga	Fox H, et al. The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. Jevtana cabazitaxel policy: Humana made the following changes to its Jevtana cabazitaxel policy: Added the following HCPCs code: C - Injection, cabazitaxel, 1 mg Read the complete update. SC [c. The technical storage or access that is used exclusively for statistical purposes. BCBS Kansas City Missouri New Prostate Cancer Screening medical policy: Prostate cancer screening with prostate-specific antigen may be covered when the following criteria visit web page met: Screening for prostate cancer with the prostate-specific antigen PSA test meets coverage criteria for all individuals aged years.
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Highmark blue cross muscle nerve study during surgery	For treatment of non-neurogenic or urge urinary incontinence in members who have undergone a trial of pelvic muscle exercises to change duration of no significant improvement in incontinence from at least six months bule at least four weeks. Respicardia is a leader in innovative technologies that address the unmet needs in respiratory and cardiovascular disease with safe and effective therapies. Added investigational policy statement for ureteral stents for all other indications. Costanzo M. Any esther baxter 2013 exceeding units per month will require prior authorization.
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Electromyography EMG is the study and recording of intrinsic electrical properties of skeletal muscles. This is carried out with a needle electrode. Results reflect not only on the integrity of the functioning connection between a nerve and its innervated muscle, but also on the integrity of a muscle itself. Nerve conduction velocity NCV also called nerve conduction study NCS is the study of a nerve being stimulated electronically through the skin and underlying tissue to measure nerve conduction time.

Results of NCV studies reflect on the integrity and function of the myelin sheath and the axon of the nerve. EMG and NCV studies are commonly performed in conjunction with each other to confirm a clinical diagnosis of the peripheral nervous system disorders.

Neuromuscular junction testing repetitive stimulation involves recording muscle responses to a series of nerve stimuli applied at differing rates, both before and after exercise or transmission of high-frequency stimuli. Testing is indicated for suspected diseases of the neuromuscular junction generally associated with progressive motor fatigability which include myopathy, focal neuropathy, Myasthenia gravis and Lambert Eaton Myasthenic syndrome.

Another condition that testing may be indicated for, botulism, is associated with a decrease in the amount of acetylcholine released, and results in weakness. EMG for any other indication is considered not medically necessary. An H-reflex test can be paid separately from any EMG studies and NCV studies listed and should be limited to one unilateral or bilateral study per session per code. An F-Wave is considered a form of nerve conduction testing.

When reported independently, it should be processed according to the number of nerves studied. Payment higher than the established allowance for an NCV study should not be made if a doctor reports that multiple methods e. None of these constitute a circumstance of such an unusual nature as to warrant additional payment.

Electrodiagnostic assessment consisting of EMG and NVC may be considered medically necessary as an adjunct to history, physical exam and imaging studies when the following criteria are met and when performed together and interpreted on the same day for ANY of the following conditions:.

A repeat electrodiagnostic assessment may be considered medically necessary when at least ONE of the following criteria have been met:. Electrodiagnostic assessment consisting of EMG and NVC for any other indications is considered not medically necessary. Repetitive Nerve Stimulation RNS in the diagnosis of a neuromuscular junction disease may be considered medically necessary for the following conditions:. RNS for any other indication is considered not medically necessary.

Neuromuscular junction testing repetitive stimulation should be processed separately and should be limited to two repetitive stimulations per session. Scientific evidence does not support the use of these tests. Needle EMG. Other Studies. Motor NCS. Sensory NCS. RNS Testing. Weakness, fatigue, cramps, or twitching focal. Weakness, fatigue, cramps, or twitching general. Refer to medical policy I Botulinum Toxin Chemodenervation for additional information.

Professional Statements and Societal Positions Guidelines. If prognostic information is required on ultimate vocal fold mobility in a patient with vocal fold paralysis that is greater than four 4 weeks and less than six 6 months in duration, LEMG should be performed.

LEMG may be performed to clarify treatment decisions in a patient with vocal fold immobility that is presumed to be caused by RLN. The policy position applies to all commercial lines of business. Services that do not meet the criteria of this policy will not be considered medically necessary. A network provider cannot bill the member for the denied service unless: a the provider has given advance written notice, informing the member that the service may be deemed not medically necessary; b the member is provided with an estimate of the cost; and c the member agrees in writing to assume financial responsibility in advance of receiving the service.

RNS Testing. Weakness, fatigue, cramps, or twitching focal. Weakness, fatigue, cramps, or twitching general. Refer to medical policy I Botulinum Toxin Chemodenervation for additional information. Professional Statements and Societal Positions Guidelines. If prognostic information is required on ultimate vocal fold mobility in a patient with vocal fold paralysis that is greater than four 4 weeks and less than six 6 months in duration, LEMG should be performed. LEMG may be performed to clarify treatment decisions in a patient with vocal fold immobility that is presumed to be caused by RLN.

The policy position applies to all commercial lines of business. Services that do not meet the criteria of this policy will not be considered medically necessary. A network provider cannot bill the member for the denied service unless: a the provider has given advance written notice, informing the member that the service may be deemed not medically necessary; b the member is provided with an estimate of the cost; and c the member agrees in writing to assume financial responsibility in advance of receiving the service.

The signed agreement must be maintained in the provider's records. The member must be provided with an estimate of the cost and the member must agree in writing to assume financial responsibility in advance of receiving the service. This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition.

Medical policies do not constitute medical advice, nor are they intended to govern the practice of medicine. They are intended to reflect Highmark's reimbursement and coverage guidelines. Coverage for services may vary for individual members, based on the terms of the benefit contract.

Highmark retains the right to review and update its medical policy guidelines at its sole discretion. These guidelines are the proprietary information of Highmark. Any sale, copying or dissemination of the medical policies is prohibited; however, limited copying of medical policies is permitted for individual use.

Written information in other formats large print, audio, accessible electronic formats, other formats Provides free language services to people whose primary language is not English, such as: Qualified interpreters Information written in other languages If you need these services, contact the Civil Rights Coordinator.

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U. They are intended to reflect reimbursement and coverage guidelines. Post a Comment. Policy Position Coverage is subject to the specific terms of the member's benefit plan. NCV is considered not medically necessary for any other indications.

Repetitive Nerve Stimulation RNS in the diagnosis of a neuromuscular junction disease may be considered medically necessary for the following conditions: Myopathy; or Motor neuropathy e. Macro EMG. Automated non-invasive electro-diagnostic testing with a computerized hand-held device e. ALS 4 4 2 0 2 Plexopathy 2 4 6 2 0 Neuromuscular Junction 2 2 2 0 3 Tarsal tunnel syndrome unilateral 1 4 4 0 0 Tarsal tunnel syndrome bilateral 2 5 6 0 0 Weakness, fatigue, cramps, or twitching focal 2 3 4 0 2 Weakness, fatigue, cramps, or twitching general 4 4 4 0 2 Pain, numbness, or tingling focal 1 3 4 2 0 Pain, numbness, or tingling general 2 4 6 2 0.

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