Ed Kensik01.09.07
National Heritage Insurance Co. (NHIC) has become the latest insurer to deny coverage of NeuroMetrix's portable nerve conduction test, according to the Associated Press.
National Heritage said in a medical coverage decision published last week that: "Testing by simple hand-held devices or using surface electrodes is not covered by Medicare."
That disqualifies NeuroMetrix's NC-stat strap-on device that allows physicians to test for problems like carpal tunnel syndrome and back pain.
The medical coverage decision didn't name NeuroMetrix or NC-stat by name, but the exclusion of the device is clear. "Hand-held devices that employ surface electrodes rather than standard needle electrodes do not provide sufficient clinical discrimination to qualify as nerve conduction studies or electromyographic studies and should not be coded as such."
NeuroMetrix has insisted for the past couple of years that physicians using NC-stat, mostly general practitioners, could bill the procedure under existing reimbursement codes covering the standard surface and needle testing procedures it competes with. Those procedures are performed by neurologists.
Although mostly expected, NHIC's decision is more bad news for Waltham, Mass.-based NeuroMetrix, whose stock has been depressed over concerns doctors might not be able to continue billing insurance companies for procedures using the device.
NHIC is a Medicare provider in California, Maine, Massachusetts, New Hampshire, and Vermont and serves about four million beneficiaries and 142,000 health care providers.
National Heritage said in a medical coverage decision published last week that: "Testing by simple hand-held devices or using surface electrodes is not covered by Medicare."
That disqualifies NeuroMetrix's NC-stat strap-on device that allows physicians to test for problems like carpal tunnel syndrome and back pain.
The medical coverage decision didn't name NeuroMetrix or NC-stat by name, but the exclusion of the device is clear. "Hand-held devices that employ surface electrodes rather than standard needle electrodes do not provide sufficient clinical discrimination to qualify as nerve conduction studies or electromyographic studies and should not be coded as such."
NeuroMetrix has insisted for the past couple of years that physicians using NC-stat, mostly general practitioners, could bill the procedure under existing reimbursement codes covering the standard surface and needle testing procedures it competes with. Those procedures are performed by neurologists.
Although mostly expected, NHIC's decision is more bad news for Waltham, Mass.-based NeuroMetrix, whose stock has been depressed over concerns doctors might not be able to continue billing insurance companies for procedures using the device.
NHIC is a Medicare provider in California, Maine, Massachusetts, New Hampshire, and Vermont and serves about four million beneficiaries and 142,000 health care providers.