Comparing ANS Testing
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.
(Do not report 95922 in conjunction with 95921)
Sudomotor function testing (CPT code 95923) (Add on component to the Intellewave, does not come with sudomotor testing in base configuration) – Used to evaluate and document neuropathic disturbances that may be associated with pain. The quantitative sudomotor axon reflex test (QSART), thermoregulatory sweat test (TST), sympathetic skin responses, and silastic sweat imprints are tests of sympathetic cholinergic sudomotor function.
Combined parasympathetic and sympathetic testing with and without the use of a tilt table are coded as follows:
Combined parasympathetic and sympathetic adrenergic functions with at least 5 minutes of passive tilt (CPT code 95924) – This should be reported only when both the parasympathetic and the adrenergic functions are tested together with the use of a tilt table. This code replaces 95921 or 95922 when ANS testing is performed with Tilt table.
(Do not report 95924 in conjunction with 95921 or 95922.)
Simultaneous, independent, quantitative measures of both parasympathetic function and sympathetic functions based on time-frequency analysis of continuous respiratory activity, with mean heart rate and blood pressure measures, during rest, paced (deep) breathing, Valsalva maneuvers, and head-up postural change (CPT code 95943) – This is autonomic function testing that does not include beat-to-beat recording or testing without the use of a tilt table.
(Do not report 95943 in conjunction with 93040, 95921, 95922, 95924)
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