S3900 — Surface electromyography (emg)
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- Development of a differential diagnosis based upon appropriate history and physical examination prior to performing testing — "Development of a differential diagnosis based upon appropriate history and physical examination" (AANEM recommendations cited).
- Testing must be medically indicated and performed using appropriate equipment that provides assessment of all parameters of the recorded signals — "The testing is medically indicated" and "It is performed using equipment that provides assessment of all parameters of the recorded signals (equipment designed for screening purposes is not acceptable)" (AANEM minimum standards).
- Needle EMG examination must be performed by a physician specially trained in electrodiagnostic (EDX) medicine — "The EMG must be performed by a trained physician" (AANEM).
Key Coverage Criteria
- Individuals being evaluated for carpal tunnel syndrome
- Nerve conduction studies with or without standard late responses (e.g., F-wave and H-reflex tests) and for neuromuscular junction testing when performed in conjunction with needle electromyography for any of the following known or suspected disorders:
- Peripheral neuropathy/polyneuropathy (e.g., inherited, metabolic, traumatic, entrapment syndromes)
- Neuromuscular junction disorders (e.g., myasthenia gravis)
- Motor neuron disease
- Radiculopathy (cervical, thoracic, or lumbosacral)
14 Active Policies
CIGNA-CPG278 — Chiropractic Care - (CPG278)
AETNA-CPB-0107 — Chiropractic Services
AETNA-CPB-0112 — Surface Scanning and Macro Electromyography
AETNA-CPB-0362 — Spasticity Management
AETNA-CPB-0752 — Obstructive Sleep Apnea in Children
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