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Date Printed: October 23, 2017: 02:16 AM

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Subject: Nerve Conduction Studies, F-Wave Studies, H-Reflex Studies

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This medical coverage guideline is not an authorization, certification, explanation of benefits, or a guarantee of payment, nor does it substitute for or constitute medical advice. All medical decisions are solely the responsibility of the patient and physician. Benefits are determined by the group contract, member benefit booklet, and/or individual subscriber certificate in effect at the time services were rendered. This medical coverage guideline applies to all lines of business unless otherwise noted in the program exceptions section.

 

DESCRIPTION

Nerve conduction, F-wave, and H-reflex studies are forms of electrodiagnostic medicine or EDX. This type of medicine may help to diagnose certain diseases of the nervous system. EDX can be used to:

• diagnose disease

• evaluate symptoms

• monitor the disease process

• measure responses to therapy.

Nerve Conduction Studies

Nerve conduction studies, or NCS, stimulate a nerve with electricity then measure the response. A sensory NCS measures the response of the nerve at locations along the nerve. A motor NCS measures the response of the muscle controlled by the nerve.

F-wave and H-reflex studies

F-wave and H-reflex studies measure the response of a nerve from the spine all the way to its associated muscle. These studies measure the response along the entire length of the nerve. F-wave and H-reflex studies may detect problems that a nerve conduction study may not.

Nerve conduction studies and F-wave or H-reflex studies are often performed together. These procedures are non-invasive and are typically performed in an out-patient setting. If an arm or leg are studied, usually the opposite arm or leg is also studied for comparison.

Visit the Clinical View of this guideline for more information.

Visit WebMD for more information on using nerve conduction studies.

COVERAGE

 

Note: For all medical decisions about this service, Florida Blue uses the Position Statement in the Clinical View of this medical coverage guideline. To make the best decision for your health needs, talk to your doctor. The services covered vary from health plan to health plan. Refer to your health plan contract for complete information about your coverage.

 

Nerve conduction, F-wave and H-Reflex studies may be covered if certain requirements are met including:

• Conservative treatments have failed

• The study is performed to assess the integrity and diagnose peripheral nervous system disease

• The study is performed by or under the direct supervision of a physician

• The study is conducted and interpreted at the same time as a needle electromyography (NEMG).

Nerve conduction, F-wave and H-Reflex studies performed without a needle electromyography may be covered if certain requirements are met including:

• The study is a follow-up evaluation after previous electrodiagnostic evaluation

• You are currently on anticoagulant therapy

• You have lymphedema

• You have carpal tunnel syndrome

• You are unable to tolerate a needle electromyography.

All other uses are considered experimental or investigational and are not covered.

Visit the Clinical View of this guideline for specific coverage information.

PROGRAM EXCEPTIONS

• Federal Employee Program (FEP): Certain exceptions apply.

• State Account Organization (SAO): Certain exceptions apply.

• Medicare Advantage products: Certain exceptions apply.

Visit the Clinical View of this guideline for more coverage information.

Refer to your health plan contract for complete information about your coverage.

Date Printed: October 23, 2017: 02:16 AM