Introduction to Mobile Testing Providers nationwide not unlike most businesses or individuals are looking for savings and ways to generate more income for their practices. Many mobile testing services are renowned for offering this opportunity. One such very prevalent and popular testing service that has been around for several decades is EMG/NCV testing or Nerve Conduction Velocity testing. This is essentially testing for nerve damage in patients and are applicable to corroborate symptoms and confirm diagnosis of Peripheral Neuropathy and Peripheral Artery Disease as well as many other forms of circulatory based disorders.
What is done in an EMG/NCV test? The testing is based off of measuring how effective the patients arteries and capillaries are at carrying blood and oxygen throughout the body to major organs. Usually lower and upper extremities are tested, the lower extremities are your legs and feet and the upper extremities are your arms and chest. These tests are noninvasive [...]
As a doctor in today’s ever changing and fast paced medical landscape, it is difficult to keep up with new regulations and laws from Medicare, in fact it’s incredibly difficult, CMS Medicare and AMA guidelines for proper protocols relating to medical procedures change without notice and seemingly without rhyme or reason, more so Medicare does not take care to properly announce or alert practitioners to these changes, often times when a doctor finds out this CPT code is no longer reimbursed or this ICD-10 code is no longer allowed, is at the edge of an Audit or a claw back from these same agencies.
So what’s changed?
So having a compliance check or compliance officer is vital to keep ahead of the curve with these types of changes, one such change specifically oriented to the Autonomic Nervous system testing arena involves CMS Medicare changing their coverage policy for ANS systems [...]
Let’s face it, we all love loopholes, exceptions, incentives, discounts and savings, and especially that much more when Uncle Sam decides he will pick up the tab for us. But funnily enough, most people have never even heard of Tax Code 179, to many it sounds like a line in an endless thousand page book of boring tax law buried in a cellar somewhere with cobwebs, never to be read except by your local CPA down the street. But actually this is not the case at all, Tax Code 179 was designed to help businesses both large and small expand and grow!
What is Tax Code 179?
Essentially, Section 179 of the IRS tax code allows businesses to deduct the full purchase price of qualifying equipment financed during the tax year. That means that if you buy (or lease) a piece of qualifying equipment, you can deduct the FULL PURCHASE PRICE from your gross [...]
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 [...]