CMS Billing and Coding for Autonomic Function Tests (A54954) Revision 01/01/23
When submitting claims to Novitas for Sudoscan and similar devices as described above, providers should report CPT code 95999. The word SUDOSCAN or the term ESC (electrochemical skin conductance) must be noted in the narrative/remarks field (Item 19) on the CMS-1500 claim form or the electronic equivalent.
Sudoscan and similar devices, by definition, do not meet the description of Current Procedural Terminology (CPT) code 95923 in that the subject preparation, environmental requirements, and specially trained medical personnel requirements are not met. Therefore, to bill this type of testing report, the unlisted neurological diagnostic CPT code 95999.
CMS Medical Coverage Determination for Autonomic Function Testing (A57551) Revision 01/01/22
Diagnostic testing may be allowed once to confirm or exclude specific autonomic diseases. For patients with diagnosed autonomic disorders, repeat testing is governed by a change in clinical status or response to a therapeutic intervention. If a repeat test is needed, it is not expected to exceed once per year.
Providers who perform these tests on an unusually high proportion of their patients or at frequencies exceeding once per year may be subject to medical review.
Providers who do not use tilt tables and are using the code range 95921-95924 may be subject to medical review.