EDX FAQ

  1. What are some of the biggest challenges facing physicians today?
  2. How are physicians overcoming these issues to maintain their practice viability?
  3. What is Electrodiagnostic Testing (EDX)?
  4. Which test can be performed in my office?
  5. How does the NCV test work?
  6. What about the SSEP test?
  7. What about the EMG test?
  8. Am I duplicating a full Neurological evaluation?
  9. What type of Physicians needs to perform these tests?
  10. What does EDX testing provide my patients?
  11. How many of my patients would be candidates for this examination?
  12. What are the Reasons to order Nerve Conduction Studies?
  13. What examples of conditions and tests would the NCV test be ordered for?
  14. As a Physician, why should I order the test?
  15. Is it convenient and cost effective for my patients?
  16. How does it work?
  17. How is the Physician trained?
  18. What is the cost of the EDX program?
  19. Do I pay extra for additional Technician Training?
  20. What is the “Fee for Service” charge?
  21. Does Medicare reimburse for the EDX test?
  22. How do I know I will get reimbursed?
  23. It sounds very interesting, but "I don't have the time?"
  24. I don't have a technician to perform the test, how will it work?
  25. How is my technician's performance monitored?
  26. Is a second opinion or over read interpretation available?
  27. When can you expect to get the test/interpretation results back?
  28. Is your program a “true” nerve conduction study?
  29. How long has Rehab Management Group Inc. been in business?
  30. Does your program meet all regulatory issues?
  31. What are the Physician responsibilities/requirements?”
  32. I like the potential, how do I get started?
  33. What are RMG's Goals?
Q:What are some of the biggest challenges facing physicians today?
A:A few of them are:

  • Carrier reimbursements are steadily decreasing for every procedure.
  • Physicians have to treat more patients' everyday to maintain previous revenues.
  • Diminishing financial returns. It is becoming impossible to treat enough patients to maintain past revenues.
Q:How are physicians overcoming these issues to maintain their practice viability?
A:They are expanding their practice dynamics by developing additional services they perform in their clinic. These are called Ancillary Services. Ancillary services are procedures or testing the Physician may have referred out in the past.

Examples: X-ray, MRI, Bloodwork, EKG, Rehab and Electrodiagnostic Testing are some of the possibilities. Let's talk about Electrodiagnostic Testing.
Q:What is Electrodiagnostic Testing (EDX)?
A:There are 3 Primary types of EDX Tests

  • NCV - Nerve Conduction Velocity
  • SSEP - SomatoSensory Evoked Potentials
  • EMG - ElectroMyoGram

It is the “Gold Standard” in diagnostic capabilities and delivers the most valuable information for differential diagnosis of Neuromuscular and Peripheral Nerve disease.
Q:Which test can be performed in my office?
A:All tests can be performed in your office. However, NCV is the primary test that will be performed in your clinic. NCV is a NON-invasive test (no needles). NCV is normally the first test ordered. Other tests may follow “depending on the results” of the NCV test.
Q:How does the NCV test work?
A: The NCV test measures how well signals travel along a nerve and can help find the cause of abnormal nerve function. Signals are made to travel along the nerve by applying small electric pulses to the nerve at one site and recording the response at a different place along the nerve. The short electric pulses cause a brief, mild tingling feeling. The nerve's response is picked up by a recording instrument and then is measured by the technician performing the test. Several nerves may need to be tested, depending on the pathology. This is an “objective” study.
Q: What about the SSEP test?
A:This is the second test performed if a Radiculopathy is suspected. This test is a painless test that checks the nerve pathways through the spinal cord. The nerve responses are recorded over the scalp. This is an “objective” study.
Q:What about the EMG test?
A:This is the “needle” portion of the EDX exam that is inserted into several muscles to see if there are any suspected Radiculopathies. Most of our clients refer this test out. Patients with muscle loss or muscle dysatrophy are usually referred to a specialist for treatment. This is a “subjective” test.
Q:Am I duplicating a full Neurological evaluation?
A:No, NCV's are ordered to help differentiate between a Radiculopathy (i.e. Disc) and a Peripheral Neuropathy (i.e. Pain from the nerve in an extremity). It is important information before any treatment plan is attempted, or to discover why previous treatment plans may not have been successful. If additional tests are needed, the physician would proceed with additional testing.
Q:What type of Physicians need to perform these tests?
A:These groups have large patient bases in need of this study.

  • Family/General Practioners
  • Orthopedic Specialists
  • Pain Physicians
  • Endocrinologists
Q: What does EDX testing provide my patients?
A:This is an “objective” test to differentiate a diagnosis of a Radiculopathy from a Peripheral Neuropathy. It assures the physician a complete picture of the neuromuscular disorder to provide cost effective and insightful treatment planning. For diabetic patients it is invaluable for evaluating, monitoring Diabetic neuropathies.
Q: How many of my patients would be candidates for this examination?
A:Family and Primary Care physician's report 30%-35% of their patients are candidates for this exam. Pain practices, orthopedic specialists, Internal Medicine and Endocrinologists report a much higher incidence of ordering the test.
Q: What are the Reasons to order Nerve Conduction Studies?
A:The following are some of the reasons to order NCV studies.

  • Patients exhibiting neck pain with radiating symptoms.
  • Patients exhibiting back pain with radiating symptoms.
  • Pain and/or numbness in extremities i.e. Arms, legs, hands and feet.
  • Weakness of extremities
  • Carpal Tunnel
  • Diabetes
  • The patient is not responding to the Physicians care as expected.
  • The patient has specific complaints, which clinical findings do not support.
  • Negative X-rays, CT scans, or MRI, but continued patient complaints.
  • The patient has suffered a traumatic injury.
  • When there is a need to substantiate the effectiveness of care.
  • When needed to determine severity of injury in Workers Comp or PI. Cases.
  • To monitor patients with neuropathies.
  • When needed to substantiate continued care when maximum insurance benefits have been reached.
Q: What examples of conditions and tests would the NCV test be ordered for?
A:
Symptom NCV Test(s) Ordered
Carpal Tunnel
Neck Pain w/radiating Symptoms
Shoulder Pain w? Radiating Symptoms
Weakness of Hands
Leg or Foot Cramps
Pins/Needles in Arms, Legs, Hands and Feet
Low Back Pain Radiating into Legs
Pain Numbness in Little Finger or Elbow
Sensory Loss of Extremities
Weakness of Extremities
Diabetes*
Tarsal Tunnel
Wrist Drop
Foot Drop		 Upper Extremity
Upper Extremity
Upper Extremity
Upper Extremity
Lower Extremity
Upper/Lower Extremity
Lower Extremity
Upper Extremity
Upper/Lower Extremity
Upper/Lower Extremity
Lower Extremity
Lower Extremity
Upper Extremity
Lower Extremity

* (Diabetes; NCV tested recommended by American Diabetes Association for evaluation and monitoring Diabetic Peripheral Neuropathy)
Q: As a Physician, why should I order the test?
A:Approximately 4 out 10 patients with neuromuscular disease are misdiagnosed without the nerve conduction study. “Misdiagnoses leads to Mistreatment”. Having the EDX ancillary services in your clinic enables you to diagnosis and treat these diseases “in your office”. (See Peer Review article, Electrodiagnosis Affects Diagnosis and Treatment Plans Division of Neurology, Penn State College of Medicine.)
Q: Is it convenient and cost effective for my patients?
A:Absolutely! It maintains the continuity and integrity of patient care in a timely fashion. It's not necessary to wait for weeks or months for a neurological consultation and additional expense for the patient of additional medical workups. It assures the Physician the ability to provide immediate treatment and control of his patients care.
Q: How does it work?
A: RMG’s EDX Program is a unique, professionally managed opportunity for the physician

  • RMG trains members of your existing staff and certifies them upon completion of our training.
  • Technicians are trained in your office with your patients.
  • There is no additional space required other than your current exam rooms
  • Equipment is the size of a laptop.
  • Physicians participate in an on-line seminar and are invited to attend additional seminars in Orlando FL, where they will be invited to join the AANEM after completion of an advanced study in EDX Medicine.
  • Education to Physicians and staff is provided for proper ordering and documentation of the tests performed.
  • Quality control of each test performed in your office is supervised by Board Certified technicians to ensure completeness and quality assurance.
  • Over read reports by Board Certified physicians are provided in 3-5 working days.
  • Instruction on approved CPT and ICD 9 coding and answers to billing questions.
  • Reactivation alerts for repeat testing, usually required annually (Diabetes).
  • HIPPA compliant database for storage and easy tracking of all reports.
  • Full library of peer review articles and instructional videos for review.
  • Assistance in procuring equipment at wholesale cost.

Every aspect of the operation has been thoroughly tested and provides the physician confidence in his newly developed EDX ancillary service.
Q: How is the Physician trained?
A: RMG provides online seminars which are available at the physician's convenience. We also have multiple one day seminars, always on Saturday across the country which are regularly attended by clients and their staff to continue their education on a variety of EDX topics including: diagnosis and treatment planning, diagnosing peripheral neuropathies, pain, tingling and numbness, diabetic polyneuropathies, and all topics concerning successful implementation of the EDX program.
Q: What is the cost of the EDX program?
A:The only cost for the program is the purchase of the EDX testing equipment. The equipment cost is $14,950. This is a wholesale cost that encompasses complete training. If the equipment is leased then the breakeven point is only one (1) test per month.
Q: Do I pay extra for additional Technician Training?
A:Training is included when you commit to our EDX Management Agreement. RMG bills the physician a “fee for services” rendered on the quality control oversight and the professional interpretations provided by our Board Certified physicians on every test you perform. We continue to train your technicians whenever the physician requests or when we feel it is necessary to improve performance of your techs skills.
Q: What is the “Fee for Service” charge?
A: We charge a flat rate per test that is never to exceed 33% of your collected revenues. This is easily determined by a quick review of your payors. If no tests are performed, no services are billed. There are no hidden maintenance or contract fees.
Q: Does Medicare reimburse for the EDX test?
A:Medicare reimburses over $425 per exam. Most carriers exceed this amount. Most clients average between $600 and $650 per test, depending on their carrier mix.
Q: How do I know I will get reimbursed?
A: All carriers recognize the CPT codes for the testing. It is the “Gold Standard” in testing. RMG reviews your top seven payors and works with your billing department to assure your insurance companies pay the codes.
Q: It sounds very interesting, but “I don't have the time?”
A:It doesn't take any more time than you would spend to refer the patient out for the same test to a specialist. We train your staff to respond to your ordering the test, just as you would if you were referring the patient to another physician. Except you get the results, quicker, (and you are assured of the patient returning to you for treatment.)

We provide custom order forms that the physician simply checks a box, documents in your notes why the test is being ordered and document the results from the exam. Just as you would normally do with any other treatment performed by you or your staff or documenting any service referred to other physicians.

RMG trains and manages your technician responsibilities, so you don't have to while they are performing the tests.

The only time requirement is the one hour on line seminar with our physician to familiarize you with the program. It is time well spent for this dynamic potential.
Q: I don't have a technician to perform the test, how will it work?
A:RMG will train members of your current staff, in your office, with your patients. We recommend a Medical Assistant who is comfortable working with patients, has an understanding of anatomy, and is computer literate. The technician is initially trained over a 3 day period at your clinic with your patients. Additional training is performed over time. We recommend 2 people for training so you have full time coverage in case of illness.
Q: How is my technician's performance monitored?
A:Every test is monitored by our Board Certified Technicians through our HIPPA compliant servers and checked for accuracy. If a test is not done correctly, the technician is notified to repeat the test. RMG is available by phone and email to assist the technician during office hours to answer any questions.

Our technicians monitor every test performed, assuring the physician that the test was done correctly before it is billed. Certificates are issued for successful completion of our training.

Q: Is a second opinion or over read interpretation available?
A:Yes, once our techs have reviewed the results from the test, it is forwarded to our Board Certified Neurologist or Physiatrist for review and a written interpretation is provided. This report is NOT a computer generated report; each test is reviewed by our physicians. Our Doctors are available for consultation on their interpretation of the test performed.
Q: When can you expect to get the test/interpretation results back?
A:Approximately in 3-5 days.
Q: Is your program a “true” nerve conduction study?
A:Yes! Our program is a true NCV test.

Unlike some other “handheld” equipment that is being marketed which is NOT a true NCV test. Be careful about claims from other companies that say they are the same. Some of these companies offer a lower cost, but the capabilities of the equipment LIMITS the number of nerves that can be tested. They cannot perform certain portions of electro diagnostics test. Ex; F-wave, H reflex and SSEP etc. They also have “computer” generated reports. Medicare clearly states they will not pay for this type of report.

OIG warns physicians to be careful using these machines. Many people bill these incorrectly, billing as an approved CPT code which it is NOT.

Q: How long has Rehab Management Group Inc. been in business?
A: RMG Inc. has been in business over 9 years and has provided services to hundreds of clinics across the country.
Q: Does your program meet all regulatory issues?
A:Yes, we are operating within all known federal and state guidelines and RMG has been thoroughly vetted by legal council, assuring the physician peace of mind in developing professional diagnostic capabilities for his patients.
Q: What are the Physician responsibilities/requirements?”
A:The only requirement for the physician is he/she has to be in the office when tests are performed.
Q: I like the potential, how do I get started?
A:To summarize our next steps:

  • Contact RMG's management team to initiate the EDX Management Agreement.
  • RMG will establish a “fee for service” after input from your billing personnel.
  • Schedule time for an Online Power Point Conference ASAP.
  • Designate 20 tests for NCV training in your office.
  • Pick 2 technicians to be trained to perform the test. Manuals will be provided for study.

RMG's training is designed to be as comprehensive and as non disruptive as possible. You are establishing a new diagnostic wing to your existing practice. RMG looks forward to being your full time manager of your EDX Direct service.

Q: What are RMG's Goals?
A:Your Goals are our Goals! We are a team of dedicated professionals who understand enhancing the Physicians practice, broadening his opportunities and exceeding his patient's expectations, is the benchmark for the physician's success.

Give us a Call!