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Medical Technologies & Procedures

Quantitative Sensory Testing (QST)

Coverage decision

The department or self-insurer does not cover use of quantitative sensory testing (QST) for the purpose of diagnosing, treating, or following patients for any condition. Diagnoses based solely or primarily on QST test results will not be accepted as allowed conditions on a Workers’ Compensation or Crime Victims’ claim.  The department or self-insured employer will not pay for follow-up treatment recommended by the provider in response to QST test results.

Noncoverage of QST includes, but is not limited to, use of sensory nerve conduction threshold testing (sNCT), current perception threshold testing (including current-input and voltage-actuated or similar devices, e.g., Neurometer® CPT, Neural-Scan™, Axon II™, Medi-Dx 7000™), and testing using the NK Pressure Specified Sensory Device (PSSD). 

Background Policy Information

QST was developed to assess sensory nerve function and measures the level at which a subject reports sensing a physical stimulus (detection threshold) applied to the skin.  QST is a subjective, psychophysical test requiring an alert and cooperative patient.  It differs from standard electrodiagnostic testing using nerve conduction studies, evoked potentials, or electromyography which objectively measures neurological function. 

Some sensory nerve evaluation techniques (e.g., Semmes Weinstein monofilaments, tuning forks) are routinely used during clinical exams; this policy is not meant to discourage their use; however, L&I considers such use part of the routine clinical exam and not a separate payable service.

Review by the Industrial Insurance Medical Advisory Committee (IIMAC)

A health technology assessment of QST was presented to the IIMAC on July 23, 2009.  Based on this review of the best available scientific literature the IIMAC advised non-coverage of QST.

About the IIMAC

The IIMAC was formed by the Washington State Legislature in 2007. RCW 51.36.140 authorizes the IIMAC to:
Advise the department on matters related to the provision of safe, effective, and cost-effective treatments for injured workers, including but not limited to the development of practice guidelines and coverage criteria, review of coverage decisions and technology assessments, review of medical programs, and review of rules pertaining to health care issues.
More information about the IIMAC is available on the L&I internet at:
http://www.lni.wa.gov/ClaimsIns/Providers/Treatment/PAC/default.asp?WT.svl=3

Additional Information

WAC 296-20-02704 What criteria does the director or director’s designee use to make medical coverage decisions?  http://app.leg.wa.gov/wac/default.aspx?cite=296-20-02704
WAC 296-20-01001 Industrial insurance medical advisory committee.  http://app.leg.wa.gov/wac/default.aspx?cite=296-20-01001

Billing Codes (HCPCS)

The following codes are not payable.

Code Type Number Description
CPT® 0106T Quantitative sensory testing (QST), testing and interpretation per extremity; using touch, pressure stimuli, to assess large diameter sensation

0107T

Quantitative sensory testing (QST), testing and interpretation per extremity; using vibration stimuli, to assess large diameter sensation

0108T Quantitative sensory testing (QST), testing and interpretation per extremity; using cooling stimuli to assess small nerve fiber sensation and hyperalgesia
0109T Quantitative sensory testing (QST), testing and interpretation per extremity; using vibration stimuli, to assess large diameter sensation
0110T Quantitative sensory testing (QST), testing and interpretation per extremity; using other stimuli, to assess sensation
HCPCS G0255 Current perception threshold/sensory nerve conduction,  test, (s-NCT) per limb, any nerve

For more information:
Contact information.

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