Autonomic Nervous System
Annualized TMC =
Unit cost per denied
claim = $143
# claims to be denied =
1,249 unique HCPs
88% par utilization 8,876 Unique customers denied
Codes 95921: Cardiovagal function testing
95922: Vasomotor function testing
95923: Sudomotor function testing
95924: Autonomic function, combined testing, with passive
95943: Simultaneous function testing, head-up posture
Vendor No Vendor Impacts
Specialties impacted Neurologists, Cardiologists, Internal Medicine, Pediatricians
What is Autonomic Nervous System (ANS) Testing?
• The autonomic nervous system controls how our organs work.
• Autonomic nervous system testing is performed on individuals with specific signs
and symptoms to help diagnose & manage autonomic nervous system dysfunction.
• These tests are PROVEN useful to diagnose some conditions; and is UNPROVEN
for other diagnoses. In many conditions testing is not clinically useful.
What is happening now?
• Coverage policy is under development.
• The CPT codes are not implemented and pay for all conditions without review.
What is changing?
• CPU will develop and post a coverage policy and implement the codes using a
• Autonomic nervous system testing (95921, 95922, 95923, 95924, 95943) will be
COVERED for specific diagnosis codes listed a medically necessary and DENIED
as EIU for all other diagnosis codes.
• Medical necessity appeal rights will be maintained. American Academy of Neurology
American Association of Neuromuscular and
Aetna, AmeriHealth Caritas
(Medicaid) Anthem, Blue Cross
Blue Shield Mississippi, First
Coast Service Options (CMS