Surface Electromyography (SEMG)
DESCRIPTION
Surface electromyography (SEMG) is a non-invasive procedure involving the detection, recording and interpretation of the electric activity of groups of muscles at rest and during activity. The procedure is performed using a single or an array of electrodes placed on the skin surface over the muscles to be tested. Recording can also be made using a hand-held device, which is applied to the skin surface at different sites. Electrical activity is assessed by computer analysis of the frequency spectrum, amplitude, or root mean square of the electrical action potential. Needle electromyography is an invasive procedure that records the electrical activity of individual muscles and is considered a more reliable technology.
Surface electromyography is occasionally used as an aid to diagnose neuromuscular disorders, determine the need for surgery in individuals with low back pain, and assist in evaluating the prognosis of disorders involving muscle lesions. The technology has also been utilized to monitor the effects of rehabilitation programs and evaluate muscular function in occupational and sports programs.
This policy only applies to the application of surface electromyography to the skin and does not apply to electromyography studies of the anal or urethral sphincter.
POLICY
Surface electromyography is considered investigational.
Policy with similar title: Needle Electromyography (EMG)
ADDITIONAL INFORMATION
There is inadequate scientific data to validate how surface electromyography is used in the care management of an individual. There is also inadequate scientific data validating that changes to individual's care management result in an overall health benefit.
SOURCES
American Association of Electrodiagnostic Medicine. (1999). Technology review: The use of surface EMG in the diagnosis and treatment of nerve and muscle disorders. Retrieved September 7, 2004 from http://www.aanem.org/practiceissues/technologyreviews/use_surface_emg.cfm. (21 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (1:2006). Paraspinal surface electromyography (EMG) to evaluate and monitor back pain (2.01.35). Retrieved June 17, 2006 from BlueWeb. (15 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (1:2003). Temporomandibular joint dysfunction (2.01.21). Retrieved June 17, 2006 from BlueWeb.
Hayes. Medical Technology Directory. (2005, December). Surface electromyography for evaluation of low back pain. Retrieved February 20, 2008 from http://www.Hayesinc.com/subscribers. (32 articles and/or guidelines reviewed)
Pullman, S. L., Goodin, D. S., Marquinez, A. I., Tabbal, S., & Rubin, M. (2000). Clinical utility of surface EMG: Report of the therapeutics and technology assessment subcommittee of the American academy of neurology. Neurology, 2000 (55), 171-177. (81 articles and/or guidelines reviewed)
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EFFECTIVE DATE |
3/27/2008 |
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ID_BT
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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