Autonomic Nervous System (ANS) Testing

This policy covers autonomic nervous system (ANS) testing to evaluate ANS integrity and function and to assist diagnosis (typically using cardiovagal, vasomotor/adrenergic and sudomotor tests such as heart rate variability, Valsalva, tilt/blood pressure response, QSART and thermoregulatory sweat testing). Coverage is limited to symptomatic patients where clinical exam and routine labs are insufficient and test results would change management (for example orthostatic hypotension, unexplained syncope/dizziness, resting tachycardia, diabetic/amyloid/immune‑mediated autonomic neuropathies, and autonomic GI/bladder/sexual or sudomotor dysfunction); testing is not covered for screening, routine monitoring, or for conditions like chronic fatigue, fibromyalgia, anxiety, or sleep apnea, and portable automated devices and several modalities (eg pupillography, gastric emptying tests, plasma catecholamines) are considered experimental or of uncertain value.

"Signs and/or symptoms of autonomic dysfunction are present."