CG-MED-24 Electromyography and Nerve Conduction Studies

This policy addresses electromyography (EMG) and nerve conduction studies (NCS). Needle EMG performed with NCS in the same session is medically necessary to diagnose neuropathy with objective sensory loss, weakness, or muscle atrophy when due to unexplained neuropathic symptoms; suspected traumatic neuropathy; to guide management in conditions known to cause neuropathy (e.g., symptomatic HIV, mononeuropathies such as Bell’s palsy, refractory diabetic neuropathy, dialysis-related); or suspected nerve impingement/entrapment with persistent symptoms unresponsive to initial conservative care (e.g., carpal tunnel). EMG/NCS are not covered when these criteria are not met or for screening; NCS or EMG alone are generally not covered; and testing for neuromuscular junction disease or unrelated conditions (e.g., back pain without radiculopathy, headaches without suspected cranial nerve disorder) is considered not medically necessary.

"Needle EMG when performed with NCS at the same time of testing are consideredmedically necessaryfor diagnosing neuropathy with sensory loss, weakness or muscle atrophy foranyof the following indica..."