Key facts for NCD 160.23
- Benefit category
- Diagnostic X-Ray Tests
- Effective date
- 04/01/2004
- Implemented 04/01/2004
- Transmittal
- Transmittal 15
- Versions published
- 2
- Manual chapter
- 160
- NCD Manual (Pub. 100-03)
TL;DR
NCD 160.23 sets Medicare's national policy for sensory nerve conduction threshold tests (sncts) under the benefit category "Diagnostic X-Ray Tests", effective 04/01/2004 and implemented 04/01/2004. All uses of sNCT to diagnose sensory neuropathies or radiculopathies are noncovered. It has been revised 1 time since publication and binds every Medicare Administrative Contractor nationally.
Item or service described
A. General
The sNCT is a psychophysical assessment of both central and peripheral nerve functions. It measures the detection threshold of accurately calibrated sensory stimuli. This procedure is intended to evaluate and quantify function in both large and small caliber fibers for the purpose of detecting neurologic disease. Sensory perception and threshold detection are dependent on the integrity of both the peripheral sensory apparatus and peripheral-central sensory pathways. In theory, an abnormality detected by this procedure may signal dysfunction anywhere in the sensory pathway from the receptors, the sensory tracts, the primary sensory cortex, to the association cortex.
This procedure is different and distinct from assessment of nerve conduction velocity, amplitude and latency. It is also different from short-latency somatosensory evoked potentials.
Effective October 1, 2002, CMS initially concluded that there was insufficient scientific or clinical evidence to consider the sNCT test and the device used in performing this test reasonable and necessary within the meaning of section 1862(a)(1)(A) of the law. Therefore, sNCT was noncovered.
Effective April 1, 2004, based on a reconsideration of current Medicare policy for sNCT, CMS concludes that the use of any type of sNCT device (e.g., “current output” type device used to perform current perception threshold (CPT), pain perception threshold (PPT), or pain tolerance threshold (PTT) testing or “voltage input” type device used for voltage-nerve conduction threshold (v-NCT) testing) to diagnose sensory neuropathies or radiculopathies in Medicare beneficiaries is not reasonable and necessary.
Indications and limitations of coverage
B. Nationally Covered Indications
Not applicable.
C. Nationally Noncovered Indications
All uses of sNCT to diagnose sensory neuropathies or radiculopathies are noncovered.
(This NCD last reviewed June 2004.)
Text reproduced from the CMS Medicare Coverage Database record for NCD 160.23 version 2. View the original on cms.gov.
Revision history
06/2004 - Reaffirmed existing Medicare noncoverage policy on any type of Sensory Nerve Conduction Threshold (sNCT) Test, and device used to perform test, to diagnose sensory neuropathies or radiculopathies. Recinds and replaces TN 8. Effective and implementation dates 04/01/2004. ( TN 15 ) (CR 3339)
03/2004 - Reaffired existing Medicare noncoverage policy on Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT). Effective and implementation dates 04/01/2004. ( TN 8 ) (CR 2988)
05/2002 - Provided that there is insufficient scientific or clinical evidence to consider this device as reasonable and necessary within the meaning of §1862(a)(1)(A) of the Social Security Act and will not be covered by Medicare. Also, established a new code G0255 for this test. The code descriptor is Current Perception Threshold/Sensory Nerve Conduction Threshold test (sNCT), per limb, any nerve - (Not covered by Medicare). Effective and implementation dates 07/01/2002. ( TN 156 ) (CR 2153)
How this NCD shows up on remittances
A service denied under a National Coverage Determination returns CARC 50 (not deemed medically necessary) with remark N386 (decision based on an NCD); a denial citing a local policy instead carries N115. Because NCDs bind nationally, the appeal path is documentation that the patient meets the indications above, not a contractor-policy argument.
How QuickIntell applies NCD 160.23
QuickAuth checks the ordered service and diagnosis against NCD and LCD criteria before the encounter, QuickCode validates the diagnosis pairing on the claim, and QuickRCM routes CARC 50 denials with the policy text and the covered-code list attached so the appeal starts with evidence.
Frequently asked questions — NCD 160.23
What does NCD 160.23 cover?
All uses of sNCT to diagnose sensory neuropathies or radiculopathies are noncovered. The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 160.23 take effect?
The current version (2) is effective 04/01/2004, implemented 04/01/2004, published in transmittal 15. CMS lists 2 versions of this NCD.
Does a Local Coverage Determination override NCD 160.23?
No. A National Coverage Determination binds all Medicare Administrative Contractors; an LCD can only address services or circumstances the NCD leaves open. Claims denied under this NCD typically return CARC 50 with remark N386 (NCD) rather than N115 (LCD).
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.
- Medicare Coverage Database NCDs via the CMS Coverage APIVersion API snapshot 2026-09-27 · effective 2026-09-20 · file national-coverage-ncd.jsonSHA-256 a90fadfd264b9ef4…
Disclaimer
This page reproduces the CMS National Coverage Determination text and, for laboratory NCDs, the CMS ICD-10 edit lists, as an operational reference. Coverage decisions depend on the full policy, the claim and the contractor; nothing here is legal, clinical or billing advice. CPT codes are shown as numbers only; CPT descriptors are copyright AMA.