Neuropsychological Testing
Neuropsychological testing may be covered when performed for the evaluation of individuals with cognitive dysfunction due to injury, disease or abnormal development of the brain. The assessments are typically performed by licensed clinical neuropsychologists, but also may be performed by neurologists, psychiatrists and psychologists. The neuropsychological examination has three general aims:

• Identification of neuropsychological dysfunction leading to conclusions regarding the presence, type and etiology of brain dysfunction by measuring attention, executive functions, sensation and perception, motor performance, memory, language and intelligence
• Comprehensive assessment of cognitive, perceptual, and motor strengths and weaknesses as a guide for treatment
• Assessment of the level of performance over a broad range, for both initial evaluation and measurement of change over time.

Examples of indications for neuropsychological testing include:

• Detection of neurologic disease based on quantitative assessment of neurocognitive abilities in conditions such as:
  • Head injuries (open or closed)
  • Anoxic injuries
  • Neurodegenerative disorders
  • Brain tumor
  • Cerebrovascular disease
  • CNS infections (e.g., HIV)
  • Demyelinating disease
  • Seizure disorder
  • Congenital or developmental disorders (e.g., cerebral palsy)
  • Extrapyramidal disease (e.g., Parkinson’s disease)
  • Chronic alcohol or drug abuse
  • Metabolic encephalopathy
  • Exposure to agents associated with cerebral dysfunction
• Differentiation between psychogenic and neurogenic syndromes such as depression vs. dementia
• Delineation of the neurocognitive effects of central nervous system disorders
• Assessment of neurocognitive functions to formulate rehabilitation and/or management strategies for individuals with neurologic disorders.

Neuropsychological testing is not covered for the following:

• Repeat testing
• Individuals with ongoing substance abuse problems, those intoxicated at the time of the testing or those who are less than 10 days post-detox
• Self-administered or self-scored inventories, or screening tests of cognitive function (e.g., AIMS, Folstein Mini-Mental Status Exam or similar tests). These types of tests are considered incidental to the E/M service and are not separately payable.
• Dementia
• Detection of cognitive deficits associated with or as a sequela to infectious disease
• Neurological sequelae of infectious diseases
• Diagnosis of infectious diseases involving the central nervous system.

The following codes may be used to describe neuropsychological testing:

96117 Neuropsychological testing battery (i.e., Halstead-Reitan, Luria, WAIS-R) with interpretation and report, per hour

ICD-9 diagnosis codes that support medical necessity for neuropsychological testing include the following (for all lines of business except Medicare & More):

290.0-294 Mental disorders (excludes codes for schizophrenic disorders and affective psychoses)

For Medicare & More members, coverage is consistent with local and national Medicare policy.

Reimbursement for neuropsychological testing battery (96117) is limited to eight hours during a 12-month period. Services in excess of this limitation are subject to medical review of documentation that supports medical necessity (i.e., office or progress notes, test results indicating specific tests performed, scoring, interpretation, length of time involved in testing).

HFCC/HFCWO Devices
High-frequency chest compression or high-frequency chest wall oscillation (HFCC/HFCWO) devices have been investigated as an alternative (not an adjunct) to conventional chest physical therapy (i.e., chest percussion and postural drainage) in the treatment of cystic fibrosis and other similar conditions. Three such devices include the ThAIRapy Bronchial Drainage System (ThAIRapy Vest), the Flutter device, and the intrapulmonary percussive ventilator (Percussionaire).

HFCC/HFCWO devices are considered investigational due to a lack of sufficient data to permit conclusions regarding an effect on health outcome and a lack of medical consensus regarding effectiveness.

The following codes may be used to describe HFCC/HFCWO devices.

S8200	Chest compression vest (investigational)
S8205	Chest compression system generator and hoses (for use with chest compression vest, S8200) (investigational)

For Medicare & More members, coverage is consistent with local and national Medicare policy.

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