The below CPT Codes are used in conjunction with ANS testing and have been deemed suitable for use with the Intellewave system and add on components like the QSART, Tilt Table, Pulse Oximetry and Ankle Brachial Index.
ANS testing can be grouped into three general categories:
Cardiovagal innervation (CPT code 95921) – A test that provides a standardized quantitative evaluation of vagal innervation to parasympathetic function of the heart. Responses are based on the interpretation of changes in continuous heart recordings in response to standardized maneuvers and include heart rate response to deep breathing, Valsalva ratio, and 30:15 ratio heart rate responses to standing.
Vasomotor adrenergic innervation (CPT code 95922) – Evaluates adrenergic innervation of the circulation and of the heart in autonomic failure. The following tests are included: beat-to-beat blood pressure and R-R interval response to Valsalva maneuver, sustained hand grip, and blood pressure and heart rate responses to tilt-up or active standing.
The Intellewave is similar to the RM3A in that it performs a twenty minute test for ANS testing, in conjunction with a tilt table, ABI or Ankle Brachial Index, and uses a syncope testing code. The core difference between the RM3A and the Intellewave is the use of ECG-based monitoring for R-R intervals while monitoring and measuring Heart Rate Variability or HRV. The reimbursements for the Intellewave also seem to be slightly higher than the average reimbursements of the RM3A system. This could be because the Intellewave utilizes the tilt table and syncope test variant. Therefore the Intellewave not only fortifies compliance for a clinic against a future audit, but also generates higher insurance reimbursement while doing so. The disadvantage however, is that the Intellewave alone does not do many of the other tests the RM3A does, those being the sudomotor, cardio-metabolic, endothelial, and insulin-resistance testing. However, the Intellewave is often [...]
Autonomic Nervous System Testing, or ANS testing as it is more commonly known, has drawn increasing amounts of popularity in the last few decades due to the alluring concept of a comprehensive analysis that provides data points highlighting imbalances in the central nervous system and imbalances between the sympathetic vs. parasympathetic systems.
RM3A Diagnostic Testing Platform
When internal systems suffer imbalances, such as in the case of patients who exhibit autonomic neuropathy, tachycardia, syncope, hypertension, or other cardiac-related conditions, then ANS testing becomes critical to isolate and identify the causes of these conditions. The RM3A device has been a gold standard for this type of testing as it performs a comprehensive twenty-minute test that not only encompasses ANS testing, but also sudomotor testing, which tests for small nerve fiber neuropathies; endothelial testing, which tests the integrity of the lining of the blood vessels; cardio metabolic testing, which tests body mass index or BMI [...]
The world of autonomic nervous system testing has been under increasing scrutiny in recent years despite being in existence since the early nineteenth century. The added attention may be due to the significant increase in billable claims from physicians nationwide for automated autonomic nervous system testing or ANS testing.
These increase of claims are not only coming from Neurologists and Cardiologist, but in fact from physicians whose taxonomy and specialty fall squarely outside the realm of being able to properly determine and interpret ANS data and information. General practitioners, family practice, internal medicine among many others join the ranks of those who are now utilizing and billing all in one comprehensive ANS testing platforms.
What do Automated ANS Systems do?
But according to the American Academy of Neurology (AAON), automated testing of ANS systems, in which software generates a report based interpretation of the patient is not yet validated. Most of [...]
The scientific and medical communities have been at odds for decades on the specific causes of Multiple Sclerosis (also known more commonly as MS). In its simplest terms, MS is an advanced neurological disorder where the auto immune system within the body is triggered to attack neural pathways in the brain. This attack on the central nervous system disrupts neural synapse firing and interrupts information from the brain to the body and vice versa. Because physicians do not know inherently the root cause of MS, it is very hard to pin point and diagnose, but the symptoms are very evident in patients. (National Multiple Sclerosis Society)
What are the symptoms of MS?
Identifying symptoms of MS might appear to be a direct and straightforward process, but that is rarely the case. According to the National Multiple Sclerosis Society, the most common symptoms of MS include fatigue, neuropathy (numbness and tingling [...]
Treatment for MS is procured based primarily on the severity of the condition. In many cases, patients might have such mild symptoms of MS that little to no treatment may be necessary. Because there is no definitive cure for MS, learning how to treat the symptoms and minimize the ongoing attacks of MS on the body from a neurological standpoint are the best mitigations of this malady. The Mayo clinic has done a good job of comprehensively compiling many of the most common treatment regiments for MS patients These may include Corticosteroids, PRP or platelet rich plasma injections, Ocrevus or antibody medications, Copaxone, Tecfidera, Abuagio, Tysabri, Lemtrada, and many other drugs have been used to help with the multiplicity of conditions that come with MS. (Mayo Clinic)
Are advanced treatments being developed for MS?
Yes, some new alternate non-drug and multidisciplinary-based treatment [...]
Physicians Practicing Regenerative Medicine in The United States
The very exciting and relatively new field of Regenerative Medicine has been and continues to be a buzz in the medical community. The key and core components of Regenerative Medicine are based on the regrowth of human tissue, organs, and even joint regrowth therapies like Osteoarthritis. These types of procedures are done in physicians’ offices nationwide, and are executed through two main avenues of treatment, the use of platelet rich plasma (PRP) and stem cell therapy.
The use of PRP and Stem Cell Therapy are for all intents and purposes the ground level and bedrock of the regenerative medicine space. In this new and ever expanding field, these have been most widely used in doctors’ offices.
But what exactly is Platelet Rich Plasma Therapy and what is Stem Cell Therapy?
According to the Virginia Tech Institute, PRP therapy is [...]
Fibromyalgia treatment is rather simple but equally daunting: to treat FM you must treat the symptoms. One of the most common and difficult symptoms is fatigue. “Fatigue is a common symptom of fibromyalgia. You may wake up in the mornings tired despite sleeping through the night. Simple everyday activities can be exhausting.” (Healthline) This is a widespread topic with treatment from simple home remedies like exercising more, practicing yoga, and taking Vitamin D supplements, to Tai Chi and massage therapy. But home remedies and simple solutions aside, physicians nationwide and in many cases internationally have been looking at more comprehensive and multidisciplinary treatment approaches to FM.
Can Biofeedback treat Fibromyalgia?
Two of many alternate research methods currently in play include biofeedback and electrical stim therapy to deal with several overarching symptoms of FM. According to Healthline, Biofeedback is about learning how to control your body functions. This [...]
One of the most debilitating and multifaceted conditions to discuss is Fibromyalgia. Clinical studies and doctors alike are still at odds on determining specifically what causes Fibromyalgia (FM) in the human body. According to Web MD, some doctors believe that FM is a problem with how the brain and spinal cord interprets pain signals from nerves.
Many doctors believe that people with a genetic precedence of FM, or those having family members who have the condition are more likely to develop it themselves. Women are also more likely than men to have FM, statistically speaking. It has also been noted that those with anxiety and depression and those who rarely exercise are more at odds to develop FM. (Web MD)
What are the Symptoms of Fibromyalgia?
There are several conditions that patients experience with Fibromyalgia, in general [...]
The widespread euphoria over the field of regenerative medicine continues to take precedence at the proverbial water cooler within the medical community. When considering the topic of sexual wellness it is not hard to imagine the buzz from men and women alike in seeking various solutions with these relatively new procedures now becoming more common and available in clinics nationwide. According to NSI Stem Cell, a fast-growing and popular condition currently being addressed by this new research is addressing ED or erectile dysfunction. (NSI Stem Cell)
What is ED and is there now a cure?
The DaSilva Institute explains that while many used to believe ED was merely a psychological condition, evidence shows that it is a multi-conditioned issue, either due to systemic diseases such as diabetes, atherosclerosis, and aging, or physical issues such as loss of blood flow, lack of nitric oxide, or nerve injury. Temporary fixes like [...]