CPT Coding 95921 from CMS:
Cardiovagal innervation – a test that provides a standardized quantitative evaluation of vagal innervation to parasympathetic function of the heart. Responses are based on the interpretation of changes in continuous heart recordings in response to standardized maneuvers and include heart rate response to deep breathing, Valsalva ratio, and 30:15 ratio heart rate responses to standing.
* Heart rate response to deep breathing, Valsalva ratio and heart rate responses to standing are evaluated by the following products : TM-Oxi, LD-Oxy, ANS-1 and TM-Flow.
CPT Coding 95923 from CMS:
Sudomotor-function testing is used to evaluate and document neuropathic disturbances that may be associated with pain. The quantitative sudomotor axon reflex test (QSART), thermoregulatory sweat test (TST), sympathetic skin responses, and silastic sweat imprints are tests of sympathetic cholinergic sudomotor function.
* Our galvanic skin response device uses the sympathetic skin responses method.
SweatC and article A54954 of Novitas:
Sweat C is not an ESC device..The word ESC means Electrochemical Skin response.
The article A54954 states: "The device measuring ESC “consist of two sets of large-area stainless steel electrodes for the hands and feet that are connected to a computer for recording and data-management purposes. The electrodes are alternately used as an anode or cathode, and a direct current incremental voltage of ≤4 V is applied to the anode. Through reverse iontophoresis, the device generates voltage to the cathode and a current (intensity of around 0.2 mA) between the anode and cathode proportional to chloride concentration.”
SweatC shall NOT be considered in this category for the following reasons:
1. It does not use steel electrodes for the hand and feet
2. It does not use incremental voltage. but constant voltage
3. It uses cloth electrodes (textile fibers) so no electrochemical reaction can be obtained, and therefore it cannot induce any reverse iontophoresis.
CPT Coding 93922 from CMS:
Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries with, transcutaneous oxygen tension measurement at 1-2 levels).
* TM-ABI and TM-Flow measure ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 2 levels.
*The above check list of CPT Codes are only suggested according to the cleared intended use of each LD Technology product, and it cannot be considered as a part of the device performances. The practitioner is solely responsible for compliance in the use of CPT codes and related ICD-10's according to the guidelines established by the AMA (American Medical Association) and CMS (Center for Medicare and Medicaid Services) Central Office per state or region. LD TECHNOLOGY shall not be liable for any changes from the AMA and/or CMS and/or for any financial damage resulting from the suggested CPT in case of practitioner's Audit.
*It is the Physicians sole responsiblity to ensure that they have the knowledge, training, expertise, and accreditation to perform these tests. The accreditation requirements are provided by CMS