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Medical Policy Revision: Autonomic Nervous System Testing

Effective January 24, 2018, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain claims for autonomic nervous system testing services.

Our medical policy, Autonomic Nervous System Testing, identifies when autonomic nervous system testing services 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 January 24, 2018 will be processed as noted below.

  • CPT® codes 0341T submitted on claims for services provided to members enrolled in Horizon BCBSNJ Medicare Advantage (MA) plans will be denied as an experimental/investigational and non-covered service, regardless of the submitted diagnosis code(s).
  • CPT codes 95921, 95922, 95923, 95924 and/or 95943 submitted on claims for services provided to members enrolled in Horizon BCBSNJ plans other than MA plans may be, based on the submitted diagnosis code(s) denied as either an experimental/investigational and non-covered service or as a service that is “not related” to the submitted diagnosis code(s).
  • Claims submitted for services provided to members enrolled in Horizon BCBSNJ plans other than MA plans that include CPT codes 95921, 95922, 95923, 95924 and/or 95943 may, based on the submitted diagnosis code(s), pend while information required to determine medical appropriateness is requested and reviewed.

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 on and after January 24, 2018.

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

Published on: October 25, 2017, 10:18 a.m. ET
Last updated on: September 11, 2020, 13:25 p.m. ET