Introduction

There are a number of physicians in Arkansas that have patients with POTS and other autonomic disorders. Until recently, it was very difficult for them to get reimbursed for tilt table testing. Most insurance companies have come around and are now paying for it. One code that works well is CPT code 95920 (Autonomic reflex screen (eg, heart rate variability, deep breathing, Valsalva maneuver, postural hypotension). The new TM Flow instrument from Meditest has made this much easier to accomplish.

Doctors have recently discovered the value of testing for Sudomotor Dysfunction by using the TM Flow

You may have heard of Sudomotor Dysfunction, but not known what it is. Sudomotor testing is a special test that measures the response of sweat glands to stimulation. Doctors can perform this test in their office and it takes only a few minutes to complete.

Most people are familiar with an activity such as exercising or getting nervous, which causes their palms to sweat; however, some medications also cause sweating and need to be taken into consideration when conducting sudomotor testing.

But since the doctor is coding the service as a diagnostic procedure, most insurance companies cover it.

In some cases, insurance companies may even reimburse for the TM Flow without requiring prior authorization—meaning that you don’t have to wait days or weeks for an answer from them before you can get your treatment.

Some patients don’t realize they can go out of network and still get reimbursed by their insurance company. The bottom line: if your physician doesn’t know what he or she is doing (and doesn’t have time to learn), then don’t come here!

Doctors are discovering the value of Sudomotor Testing with TM Flow

Tilt table testing is a relatively new procedure, but it’s gaining popularity in the medical community. This process allows doctors to evaluate how well your body responds to changes in gravity. Some people experience difficulty with this test because they have issues with their autonomic nervous system.

Doctors are discovering that TM Flow can be used as an alternative or complement to tilt table testing. The TM Flow provides data about your autonomic nervous system, which can help them determine if you’re at risk for heart attack and stroke by measuring your basic heart rate variability (HRV).

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Tilt table testing is reported with CPT code 95921 (Tilt table evaluation).

Tilt table testing is a simple and effective way to measure the activity of your autonomic nervous system. In this test, you are placed on a table and left to rest for approximately 30 minutes. The table is then tilted from 0 degrees to 60 degrees in increments of 5 degrees every 3-5 minutes until you reach maximum angle. While on the tilt table, your doctor will monitor for signs of orthostatic hypotension (low blood pressure), postural tachycardia syndrome (excessive increase in heart rate from head up position), changes in skin color and temperature, sweating or other symptoms caused by abnormal sympathetic tone.

Reimbursement usually pays about $100-130 on average for cardiac autonomic reflex tests and $200-250 on average for tilt table testing. Obviously, this will vary depend on many factors such as the patient’s demographics and their insurance benefits. However, these numbers do tend to be fairly consistent across different geographic locations in general.