AUTONOMIC NERVOUS SYSTEM TESTING

Some practices seem to treat the symptoms (pain, dizziness, insomnia, depression, Erectile Dysfunction, fatigue, etc) instead of the cause.  Think back to when you were in medical school and were excited about treating the ANS - get excited again.

• SUDOMOTOR FUNCTION - Tests the small nerve fibers in the bottom of the feet to detect Parasympathetic Dysfunction prior to the patient realizing they have symptoms.
• ANS HRV Test - tests the sympathetic and parasympathetic nerves at the same time - letting you know whether the symptoms the patient is experiencing is caused by an imbalance in the ANS.
• BASIC ABI - using plethsmography

• 95923 - Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (QSART), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential
• 95921 - Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded R-R interval, Valsalva ratio, and 30:15 ratio
• 93922 - Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, Doppler waveform recording and analysis at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries with, transcutaneous oxygen tension measurement at 1-2 levels)

(the codes you will bill will depend on not only what equipment you have, but what is medically necessary and what was performed)

• 95923:  Avg Medicare Allowed:   134.20
• 95921:  Avg Medicare Allowed: $ 94.22
• 93922: Avg Medicare Allowed: $ 87.77

TYPICAL ALLOWED PER TEST:         Medicare:  $316.19   

Most primary care practices are seeing 20 patients a day, most of whom would qualify for this diagnostic test.   Based on an average acquisition cost of $37,500, plus the typical consumable cost of $3.10 per test, testing two patients a day (5 days a week), a typical client should expect:

Gross Income:                                                                           $14,058.45

Operating Expense Incl Lease & Consumables                $     961.54

Net Monthly Profit                                                                  $ 13,006.91

Annual Net Profit                               $  157,162.95 

2.8 Tests Per month to break even on Capital Lease

2.9 Months to Full Recovery on Investment

Annual ROI:                                      419%

Typical Mutual Funds                      10%

It's better to invest in yourself and your clinic!

E03.8 Other specified hypothyroidism   

E10.41 Type 1 diabetes mellitus with diabetic mononeuropathy   

E10.42 Type 1 diabetes mellitus with diabetic polyneuropathy   

E10.43 Type 1 diabetes mellitus with diabetic autonomic   (poly)neuropathy   

E10.44 Type 1 diabetes mellitus with diabetic amyotrophy   

E10.49 Type 1 diabetes mellitus with other diabetic neurological   complication   

E10.610 Type 1 diabetes mellitus with diabetic neuropathic arthropathy   

E10.610 Type 1 diabetes mellitus with diabetic neuropathic arthropathy   

E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy   

E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy   

E11.43 Type 2 diabetes mellitus with diabetic autonomic   (poly)neuropathy   

E11.44 Type 2 diabetes mellitus with diabetic amyotrophy   

E11.49 Type 2 diabetes mellitus with other diabetic neurological   complication   

E11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathy   

E11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathy   

E11.65 Type 2 diabetes mellitus with hyperglycemia   

E13.41 Other specified diabetes mellitus with diabetic mononeuropathy   

E13.42 Other specified diabetes mellitus with diabetic polyneuropathy   

E13.43 Other specified diabetes mellitus with diabetic autonomic   (poly)neuropathy   

E13.44 Other specified diabetes mellitus with diabetic amyotrophy   

E13.49 Other specified diabetes mellitus with other diabetic   neurological complication   

E13.610 Other specified diabetes mellitus with diabetic neuropathic   arthropathy   

E287.310 Symptomatic premature menopause   

E85.0 Non-neuropathic heredofamilial amyloidosis   

E85.0 Non-neuropathic heredofamilial amyloidosis   

E85.1 Neuropathic heredofamilial amyloidosis   

E85.1 Neuropathic heredofamilial amyloidosis   

E85.3 Secondary systemic amyloidosis   

E85.3 Secondary systemic amyloidosis   E85.4 Organ-limited amyloidosis   

E85.8 Other amyloidosis   

E86.0 Dehydration   

F33.0 Depression   

F41.8 Anxiety   

F52.31 Female orgasmic disorder   

F52.32 Male orgasmic disorder   

G20 Parkinson's disease   

G23.0 Hallervorden-Spatz disease   

G23.1 Progressive supranuclear ophthalmoplegia   [Steele-Richardson-Olszewski]   

G23.2 Striatonigral degeneration   

G23.8 Other specified degenerative diseases of basal ganglia   

G40.89 Other seizures   

G44.221 Chronic tension headache, intractable   

G47.00 Insomnia   

G47.9 Sleep Disturbance   

G47.33 Obstructive sleep apnea   

G56.83 Other specified mononeuropathies of bilateral upper limbs   

G60.3 Idiopathic progressive neuropathy   

G60.8 Other hereditary and idiopathic neuropathies   

G60.9 Hereditary and idiopathic neuropathy, unspecified   

G61.82 Multifocal motor neuropathy   

G90.09 Other idiopathic peripheral autonomic neuropathy   

G90.1 Dysautonomia   

G90.3 Multi-system degeneration of the autonomic nervous system   

G90.50 Complex regional pain syndrome I, unspecified   

G90.511 Complex regional pain syndrome I of right upper limb   

G90.512 Complex regional pain syndrome I of left upper limb   

G90.513 Complex regional pain syndrome I of upper limb, bilateral   

G90.521 Complex regional pain syndrome I of right lower limb   

G90.522 Complex regional pain syndrome I of left lower limb   

G90.523 Complex regional pain syndrome I of lower limb, bilateral   

G90.59 Complex regional pain syndrome I of other specified site   

G90.8 Disorders of autonomic nervous system   

I10 Primary Hypertension   

I15,.9 Secondary Hypertension   

I50.20 Congestive Heart Failure   

I95.1 Orthostatic hypotension   

K58.0 IBS with diarrhea   

L74.4 Anhidrosis   

N39.41 Urge incontinence   

N39.498 Other specified urinary incontinence   

N52.8 Erectile Dysfunction   

R00.0 Tachycardia, unspecified   

R32 Urinary incontinence   

R53.81 Malaise   

R53.82 Chronic Fatigue   

R55 Syncope and collapse   

R61 Generalized hyperhidrosis   

R63.4 Abnormal weight loss