What doctors seem to miss about automated ANS systems
The use of ANS based CPT Codes with automated testing systems has become problematic to say the least, let’s analyze for instance CPT Code 95922, which requires a 5 minute tilt table test and continuous beat to beat blood pressure monitoring in order to be compliantly billed. That within itself is a disqualifying factor, because most automated testing systems to date do not provide tilt table and continuous blood pressure monitoring, they evaluate data points based on the testing parameters of a single point in time with respect to heart rate variability. This is not sufficient enough to make a confirmed diagnosis of anything, but doctors are actively being convinced that it is not only passable, but billable to private insurances and even Medicare. If this trend continues unchecked there could be dire repercussions for those practices that do not heed the warnings of proper billing parameters needed for ANS testing. Audits and claw backs are as real as they are feared in the medical community, and educating one’s self is the best defense against them.
PPG VS ECG, what does CMS think?
Another important point to take note of is how these data points are being gathered, CMS has mandated that Plethysmography or PPG based systems are not accurate in its capacity in gathering sufficient data from the patient for ANS based abnormalities or inconsistencies. Instead they recommend ECG or electrocardiogram based systems that use placement of electrodes across the chest to interpret data more consistently over time, thus relaying more accurate measurements and more reliable prognosis for the patients. PPG based systems however have become very popular because of their high tech and modern appearance, and the attractive thought of simply standing and laying your hands on silver plates that capture your sympathetic vs parasympathetic activities certainly sounds futuristic and does capture some data, but is simply not up to snuff as far as Medicare is concerned, not yet anyway.
Intellewave ANS test
Needless to say physicians must be careful to evaluate these automated systems before purchasing, according to the AAON, CPT Code 95943 Is the only code appropriate for ANS testing using automated systems on their own. This reimbursement will be significantly less as it does not qualify the parameters of the 95921-95922 and 95924 which is needed to have superior reimbursement.
There are however a handful of devices that do provide all the necessary components to bill out properly for ANS testing. One of these that we have examined carefully is the Intellewave platform. This all in one diagnostic testing system which is ECG based and comes with tilt table, beat to beat blood pressure monitoring and ABI or brachial index testing system for vascular testing of the patient. This not only checks all the boxes to correctly use CPT Codes 95921-95924, 93660 and extremity arterial codes like 93923-93924 to generate maximum reimbursement, but it allows the physician to remain fully compliant and provide the best quality of data generation for their patients on the market to date.
For more information on billable ANS CPT Codes and maximizing your reimbursements please call 561-408-8138 to speak to a specialist.