Position Statements

Use AANEM's position statements to better communicate with legislators, payers, and other medical professionals. 
 

Communicating About Insurance Policies

• Electrodiagnostic Medicine: Pay for Quality – Demonstrates that value based (VB) payment models for electrodiagnostic (EDX) services provide quality patient care, ensure timely treatment, and reduce health care costs. A sample payment method is included.
• Definition of Real Time Onsite – Defines the terms used in the CPT codes for nerve conduction studies (NCSs) and clarifies that studies should not be read offsite.
• Proper Performance of Autonomic Function Testing - Addresses qualifications and training required to perform autonomic tests, as well as the appropriate performance.
• Proper Performance and Interpretation of Electrodiagnostic Studies – Stresses AANEM’s position that needle EMG and NCSs should be performed together in most cases.
• Recommended Policy for Electrodiagnostic Medicine – Helps identify overutilization by providing detailed information on appropriate coding and billing. This document is frequently used by insurance companies when developing policies.
• Model Policy for Needle EMG and NCSs – Provides insurance companies with language they can easily adapt to their policies outlining AANEM’s key positions.
• Who is Qualified to Practice Electrodiagnostic Medicine? – Clearly states AANEM’s position that EDX studies should be performed by neurologists and physical medicine and rehabilitation (PMR) physicians and that technologists should only perform NCSs under direct supervision.
• Waveform Hard Copies Not Required for Reimbursement – Addresses the issue of requiring physicians retain hard copies of NCS waveform results.
• Billing for Same Day Evaluation and Management and Electrodiagnostic Testing – Addresses when  to bill for an evaluation and management code in addition to needle EMG and NCS codes.
• Technologists Conducting NCSs and SEPs Independently to be Reviewed by a Physician at a Later Time – Clearly states that a technologist may perform a NCS or SEP independently, without a physician in the room, but a qualified physician must be immediately available.

 

Working with insurance carriers or policy makers? Use these position papers:

• AMA's Prior Authorization and Utilization Management Reform Principles - AANEM endorses the American Medical Association's Prior Authorization and Utilization Management Reform Principles.
• AANEM endorses both the American Academy of Neurology's (AAN) and the American Academy of Physical Medicine and Rehabilitation's (AAPM&R) position statements on the prescription and use of opioids:
  • American Academy of Physical Medicine and Rehabilitation Position Statement on Opioid Prescribing
  • AAN Position:  Opioids 
• Principles for Health Care Delivery - AANEM endorses the American Academy of Neurology's position statement with the addition of "neuromuscular care" to the final bullet point.
• Overview of Electrodiagnostic Medicine – Provides a broad overview of EDX medicine, qualifications, laboratory organization, reporting, patient comfort, and equipment.
• Quality Electrodiagnostic Medicine Controls Costs
• Mobile Electrodiagnostic Laboratories Provide Substandard Patient Care
• Common Indicators Suggesting Fraud & Abuse in Electrodiagnostic Medicine: In an effort to help stem the tide of fraud and abuse in EDX medicine, AANEM has compiled a list of potential red flags that may indicate a provider is committing EDX fraud or abuse.

 

Communicating About Qualifications 

Use the following position papers in addition to Who is Qualified to Practice Electrodiagnostic Medicine? to address qualification and credentialing issues.

• Neuromuscular Ultrasound Qualifications – Prerequisites for a qualified physician to perform and interpret NM ultrasound.
• Credentialing of Physicians as Electrodiagnostic Medicine Consultants – Assists institutions in granting clinical staff privileges to EDX physicians.  

Practice Aids

• Establishing Standards for Acceptable Waveforms in Nerve Conduction Studies -- Clarifies what constitutes an acceptable waveform in the practice of electrodiagnostic (EDX) medicine. 
• The Utility of Genetic Testing in Neuromuscular Disease: A consensus from the AANEM on the clinical usefulness of genetic testing in the diagnosis of neuromuscular disease.
• AANEM Policy Statement on Electrodiagnosis for Distal Symmetric Polyneuropathy - Assists physicians in determining when it may be appropriate or necessary to perform EDX testing for evaluation of DSP.
• Risks in Electrodiagnostic Medicine – Assists EDX physicians in recognizing and addressing potential complications.
• Guidelines for Ethical Behavior Relating to Clinical Practice Issues in Neuromuscular and Electrodiagnostic Medicine - Instructs physicians in NM and EDX medicine on recognizing and addressing ethical issues that may arise in their practice.
• Continuous Quality Improvement in Neuromuscular and Electrodiagnostic Practice – Outlines quality improvement processes and provides guidance on their implementation in an EDX and NM practice.
  • Quality Improvement Resources and Glossary
• Referral Indications for Primary Care Providers – Assists physicians in determining whether or not a referral for an EDX medicine consultation may be useful for a patient.
• Reporting Results of Needle EMG and NCSs – Describes the information to include in an EDX report and the best way to present it.
  • Model Report
  • Report Checklist
• Reporting Results of Diagnostic Neuromuscular Ultrasound: An Educational Report – Describes the information to include in a diagnostic NM ultrasound report and the best way to present it.
  • Sample Neuromuscular Ultrasound Report
• Job Descriptions for NCS Technologists – Assists EDX laboratory directors by providing guidelines for federal and state agencies and hospital administrators concerned with classification of personnel.
• Responsibilities of a Nerve Conduction Technologist – Outlines specific duties an EDX technologist may perform under the direct supervision of a qualified physician.
• Electrodiagnostic Study Instrument Design Requirements – This statement is intended to define the requirements and specifications of a useful EDX instrument.

Education

• Educational Guidelines for Electrodiagnostic Training Programs – This was created to aid training program directors in establishing new EDX training programs or in reviewing the current status of existing programs.
• NM Medicine & Clinical Neurophysiology Fellowship Timing & Response to the AAN Position Statement - The American Academy of Neurology (AAN) has created a position statement that encourages all neurology fellowship programs to participate in a unified determination date for neuromuscular medicine fellowship. The AAN is seeking endorsement of their position from the AANEM.