Anthem Blue Cross Connecticut Commercial Clinical Policy

Anthem Blue Cross Connecticut MED.00101 Physiologic Recording of Tremor using Accelerometer(s) and Gyroscope(s) Form

Effective Date

NA

Last Reviewed

02/16/2023

Original Document

  Reference



This document addresses a type of tremor analysis device that includes an accelerometer and a gyroscope. These devices are proposed for use in diagnosing tremor, in the management of individuals with implanted deep brain stimulation devices to guide adjustments to the neurostimulator settings, and other indications.

For information on additional testing, see:

  • CG-ANC-08 Mobile Device-Based Health Management Applications
  • CG-MED-24 Electromyography and Nerve Conduction Studies
  • MED.00092 Automated Nerve Conduction Testing

Position Statement

Investigational and Not Medically Necessary:

The use of accelerometer/motion analysis testing devices is considered investigational and not medically necessary for all applications, including, but not limited to, the evaluation of tremors.