Autonomic Nervous System Testing

One in ten Americans have been diagnosed with and suffer from diabetes. Initial and regular testing for peripheral and cardiovascular neuropathy is one of the most important things that a doctor can do for their diabetic patients.

Improve Clinical Outcomes for Your Diabetic Patients

Diagnose peripheral and cardiac neuropathy before it becomes symptomatic with autonomic nervous system (ANS) testing.

Autonomic Nervous System Testing allows your practice to perform this crucial testing. This equipment measures galvanic skin response and Heart Rate Variability through a simple, quick, and non-invasive test that gives providers the ability to detect neuropathy before it becomes symptomatic.
Peripheral and cardiovascular neuropathy are among the largest concerns for diabetic patients , and it has been repeatedly proven that the earlier this condition can be detected and treated, the more likely a patient is to live a long and healthy life. Current estimates put the likelihood that a diabetic patient showing physical symptoms of peripheral neuropathy will survive through the next five years at between only 25 and 50 percent. By catching this condition through regular testing, health care providers can make a positive difference.

Autonomic Nervous System testing require only minutes to set up and operate – the benefits for your patients last a lifetime. Also, with insurance billing codes that work with major private insurance, including Medicare, you can be sure that this is one solution that truly benefits your practice as well.

Benefits To Your Practice

Easily interpreted and readable reports

No skin punctures or biopsies

Proven, reimbursable diagnosis codes for private insurance and Medicare

Excellent opportunity to be a very lucrative add-on to any existing practice

Minimal effort and training for staff

Depending on the specific state insurance: reimbursement for the test ranges
from $250-440

Testing just 2-3 patients a day would create an additional $ 11,000 – $25,000 in monthly revenue

We can provide either a service model for offices who prefer a no cost start up or equipment purchase

Easy financing options through AMS

Sudomotor Dysfunction

Sudomotor dysfunction is defined as decreased sudomotor activity. The pathological state known as sudomotor dysfunction is the earliest clinically detectable stage of sympathetic autonomic neuropathy and peripheral distal neuropathy.

Sudomotor dysfunction is often asymptomatic. Reduced C – Fiber density and/or microcirculatory disorders may be associated with chronic pain, decreased peripheral blood flow with cold extremities and/or tingling in the toes. Nerve conduction studies assess A and B nerve fibers and do not test for the C fibers that are implicated in diabetic neuropathies.

How Does The Test Work?

The Autonomic Nervous System Testing equipment is easy to use and very mobile. It’s simply plugged in to the laptop provided through the USB port and runs through proprietary software.

Dependent on the equipment chosen, a rapid evaluation of sudomotor function is performed or sudomotor and heart rate variablility (HRV) and arterial elasticity.

The test is non invasive, has high patient acceptance and requires no specialized training to operate the equipment. The testing takes no longer than 7 minutes and provides valuable insights into patient health and wellness through the detailed information and the easy to interpret color coded report.

With ANS testing,  sudomotor function is assessed and in addition the patient performs some simple breathing exercises that affect the HRV.The report enables the physician to determine any further testing required and course of treatment.

This is a doctor discussing how the equipment has benefited their practice.

Testing patients when they are diagnosed with Type II diabetes and then at regular intervals in the following years can detect Sudomotor and Autonomic Dysfunction and greatly improve your patients’ clinical outcomes.

Start-up and Implementation

How Does It Work?

Your Certified Ancillary Consultant will work with you to determine the best Autonomic Nervous System testing solution for your practice. If you would like to finance this equipment, AMS also offers easy equipment financing solutions.

Proven Reimbursement Codes

Suggested CPT Codes:

95921: Testing of autonomic nervous system function; cardiovagal innervations (parasympathetic function)

95923: The appropriate code for galvanic skin response

95943: has been established to report when an autonomic function testing does not include beat–to–beat recording, or for testing without the use of a tilt table. This is a simpler, automated procedure compared to the other autonomic codes.

93922: Ankle Brachial Index

*Do not report 95943 in conjunction with 93040, 95921, 95922, and 95924

Suggested ICD-10:

A list is available on request

We are able to offer a ANS service that eliminates the need for purchase of the equipment to suitably qualified practices.

Determine if equipment or a service model is best for your practice.

Learn how to use your new equipment with our assistance. The test can be performed by anyone on your staff, MA level or above.

Begin to test your patients when they are diagnosed with Type II diabetes and at regular intervals going forward.

The Galvanic Skin Test delivers easy-to-read results, enabling patients to get ahead of the serious complications of neuropathy.

After 100 patients have been tested and followed-up, your device has been paid for.


Peripheral Neuropathy is a disorder of the peripheral nerves—the motor, sensory, and autonomic nerves that connect the spinal cord to muscles, skin, and internal organs. It usually affects the hands and feet, causing weakness, numbness, tingling, and pain.Peripheral Neuropathy’s course is variable. It can come and go, slowly progressing over many years, or it can become severe and debilitating. However, if diagnosed early, peripheral neuropathy can often be controlled.

Why Have We Heard So Little About Peripheral Neuropathy?

Peripheral Neuropathy is common. It’s estimated that upwards of 20 million Americans suffer from this illness and can occur at any age, but is more common among older adults. A l999 survey found that 8-9% of Medicare recipients have Peripheral Neuropathy as their primary or secondary diagnosis. The annual cost to Medicare exceeds $3.5 billion.

Peripheral neuropathy has always been present, but has not received much attention. Its extent and importance have not yet been adequately recognized, and is apt to be misdiagnosed or thought to be merely a side effect of another disease like diabetes or cancer or kidney failure. The development of new therapies has unfortunately been slow and under-funded.

What Causes Peripheral Neuropathy?

There are many causes of neuropathy. Approximately 30% of neuropathies are “idiopathic,” or of an unknown cause. In another 30% of cases, the cause is diabetes. Other neuropathy causes include autoimmune disorders, tumors, heredity, nutritional imbalances, infections or toxins.

Can Peripheral Neuropathy Be Cured?

Some types of peripheral neuropathy can be cured, and while most cannot, many can still be helped. Therapy is directed at treating the underlying disease and at improving the symptoms with the right medications. An experienced neurologist can help patients feel more comfortable, and their quality of life can be greatly improved. It is extremely important to get to an experienced neurologist as soon as you
notice the symptoms before the disease has a chance to cause extensive,
permanent damage.

The Bottom Line

Autonomic Nervous System Testing simply makes sense for your practice and your diabetic patients. Insurance recognizes the need for proactive neuropathy testing and Galvanic Skin Response testing, using CPT code 95923 and others. At the average reimbursement rate of $400 per test:

Testing 1 Patient Per Day:

$400 per day

$8,000 per month

$72,000 per year

Testing 2 Patients Per Day:

$800 per day

$16,000 per month

$144,000 per year

The ANS device can be paid off in as little as one or two months and the entire purchase cost is a tax deduction.Financing options are available.

Grow your practice and offer your patients proactive testing to ensure their continued health and wellness.