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Medical Policy Implementation: Autonomic Nervous System Testing

Effective October 9, 2017, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain claims for tests of the autonomic nervous system.

Our medical policy, Autonomic Nervous System Testing, identifies circumstances under which tests to determine and or assess dysfunction of the nervous system are considered medically necessary or investigational.

We encourage you to review this policy in our Medical Policy Manual.


Based on the guidelines of our medical policy, Autonomic Nervous System Testing:

  • Claims for services provided on and after October 9, 2017 that include CPT® codes 95921, 95922, 95923, 95924 and/or 95943 may pend – based on the submitted diagnosis code(s) – while information to help us determine if the service in question is to be considered medically necessary is requested and reviewed.
  • CPT codes 95921, 95922, 95923, 95924 and/or 95943 included on claims for services provided on and after October 9, 2017 may be denied – based on the submitted diagnosis code(s) – as an experimental/investigational non-covered service or for a procedure code/diagnosis code mismatch.
  • CPT code 0341T included on claims for services provided on and after October 9, 2017 will be denied as an experimental/investigational, non-covered service regardless of the submitted diagnosis code(s).

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service on and after October 9, 2017.

CPT® is a registered mark of the American Medical Association.

Published on: July 10, 2017, 11:48 a.m. ET
Last updated on: July 10, 2017, 11:50 a.m. ET