95904
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- No explicit documentation requirements (medical record/test result) section is provided in the CPB
- Operational/test subject conditions noted in the policy that should be met for QST: “the subject must be able to comprehend what is being asked by the test, alert and not taking mind-altering medications, and not biased to a certain test outcome.”
- Policy discussion/critique notes that limb temperature control and appropriate reference populations are important methodological considerations (e.g., AAEM critique that limb temperature was controlled in only one study and reference populations often not studied)
1 Active Policy
AETNA-CPB-0357 — Quantitative Sensory Testing Methods
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