SUDOSCAN


Apparently, IMPETO filed for a Chapter 7 in the U.S. Bankruptcy Court Southern District of California (San Diego), Bankruptcy Petition #: 17-05927-CL7. It is my understanding that Impeto is still operating under the French entity and plans to eventually create a new US entity. They said that "purchase of plates and support continues" and if you need either, please call 858 450-2800 x 202 and their fax is 858 450-2804. I hope they do recover from this as alot of clients have the Sudoscan and it helps the doctors help the patients. 

As to Medicare claims, as a reimbursement consultant, I caution you to check with your Medicare carrier, as 11 STATE LCD'S (LCD 35395), STATE THAT CODE 95923 CANNOT BE BILLED FOR A DEVICE THAT USES THE METAL PLATES (exact wording is below).

​THERE IS NO REASON TO PANIC

THERE ARE OPTIONS.
CALL 903 871-1172 AND LET US SHOW YOU YOUR MEDICARE HISTORICAL BILLING DATA WE ALREADY HAVE ON OUR COMPUTER ON YOUR PAST BILLING AND SHOW YOU WHAT THOSE OPTIONS ARE.

IDENTICAL WORDING IN

NCD 54954 Autonomic Function Tests
and
Novitas LCD 35395, updated April 2017


IndicationsAccording to a report from Casellini, et al. (2013), use of an apparatus for testing electrochemical skin conductance (ESC) that "consist of two sets of large-area stainless steel electrodes for the hands and feet that are connected to a computer for recording and data-management purposes. The electrodes are alternately used as an anode or cathode, and a direct current incremental voltage of ≤4 V is applied to the anode. Through reverse iontophoresis, the device generates voltage to the cathode and a current (intensity of around 0.2 mA) between the anode and cathode proportional to chloride concentration. At low voltages (<10 V), the stratum corneum is electrically insulating, and only sweat-gland ducts are conductive [in theory]." The report continues saying the (ESC) "expressed in microSiemens (µS), is the ratio between the current generated and the constant DC stimulus (≤4 V) applied to the electrodes. During the test, patients were required to place their hands and feet on the electrodes and to stand still for 2–3 min. The device produces ESC results for individual right and left hands and feet. It then calculates an average score between right and left hands and feet. All the ESC results [presented in this study] correspond to the average ESC between right and left sides for both hands and feet. Neither special subject preparation nor specially trained medical personnel are required."

These devices (by definition
Sudoscan and similar devices) do not meet the definition of CPT code 95923. Therefore this type of testing will need to be billed with the unlisted neurological diagnostic procedure code 95999 along with “Sudoscan” or “ESC” (electrochemical skin conductance) in the comment section.




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