Electrodiagnostic Testing (EMG/NCV) - (CPG129)

Cigna considers combined needle EMG and nerve conduction studies with real‑time on‑site interpretation medically necessary for a defined list of neuromuscular indications (myopathies, neuropathies, radiculopathies, plexopathies, neuromuscular junction disorders, symptom-driven presentations, etc.), permits NCV alone only in limited situations (e.g., anticoagulation, significant lymphedema, acute nerve injury within 3 weeks, select carpal/tarsal/fibular/thoracic outlet scenarios) and specifically excludes automated noninvasive NCV (e.g., CPT 95905), macro/surface/paraspinal SEMG (HCPCS S3900), unsupervised or delayed interpretation, routine screening/monitoring (e.g., diabetic polyneuropathy, ESRD), and any indications not listed. Key requirements include clear clinical justification and listed ICD‑10/CPT codes, complete numerical NCS/EMG data and on‑site raw waveforms, continuous limb temperature monitoring, documented personnel credentials and real‑time interpretation, and documentation for repeat testing; needle EMG is allowed for injection localization and SFEMG for myasthenia gravis when RNS is negative.