Laboratory - Nerve Fiber Density Testing (Medicare Advantage Payment Policy)
Humana's Medicare Advantage payment policy for laboratory testing of nerve fiber density (including measurement of sweat gland nerve fiber density, CPT 88356) describing reimbursement stance and applicable procedures for Medicare Advantage members and providers.
No material clinical or coverage changes in this revision.
Coverage Criteria and Evidence
inv-01: Non-reimbursable scenarios and applicable procedure
For Medicare Advantage plans, measurement of sweat gland nerve fiber density (CPT 88356) is specifically not reimbursable in the following situations:
ALL of the following
ONE of
- An individual presents with symptoms of painful sensory neuropathy
- There is no history of a disorder known to predispose to painful neuropathy (examples: diabetic neuropathy, toxic neuropathy, HIV neuropathy, celiac neuropathy, inherited neuropathy)
Applicable procedure for Medicare Advantage plans: CPT 88356 - Morphometric analysis; nerve
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