DESCRIPTION
Sterile needle electrodes are inserted into the small muscles of the penis. The test attempts to evaluate motor efferent, autonomic, cavernosal nerves and muscle fiber.
POLICY
Corporal cavernosal electromyography in the diagnosis of erectile dysfunction is considered not medically necessary.
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
SOURCES
Bird, S. J., & Hanno, P. M. Bulbocavernosus reflex studies and autonomic testing in the diagnosis of erectile dysfunction. Journal of the Neurological Sciences, 154 (1), 8-13. Abstract retrieved August 1, 2001 from PubMed database.
BlueCross BlueShield Association, Medical Policy Reference Manual. (4:2002). Erectile Dysfunction (2.01.25). Retrieved March 11, 2008 from BlueWeb.
Ho, K. H., Ong, B. K, Chong, P. N. & Teo, W. L. (1996). The bulbocavernosus reflex in the assessment of neurogenic impotence in diabetic and non-diabetic men. Annals of the Academy of Medicine, Singapore, 25 (4), 558-561. Abstract retrieved August 1, 2001 from PubMed database.
Shafik, A., Shafik, A. I., El Sibai, O., Shafik, A. A. (2007). Electrophysiologic activity of the tunica albuginea and corpora cavernosa: Possible role of tunica albuginea in the erectile mechanism. The Journal of Sexual Medicine, 4 (3), 675-679. Abstract retrieved March 10, 2008 from PubMed database.
ORIGINAL EFFECTIVE DATE: 4/27/1998
MOST RECENT REVIEW DATE: 4/10/2008
ID_BA
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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