EMG and nerve conduction studies (NCS) are performed to assist the treating physicians in making a diagnosis that would direct the patient’s treatment. In order for the results of the study to be utilized, the EMG & NCS must be considered “medically useful”. The failure for an exam to satisfy medical usefulness is determined by a number of factors including, but not limited to:

1. Lack of adherence to the American Association of Neuromuscular & Electrodiagnostic (AANEM) guidelines governing the performance of EMG and NCS
2. Incompleteness of the examination
3. Inconsistency and un-reliability of data

When a study is not considered to be medically useful, several actions are possible. In some cases, if the study is considered to be deficient because the examiner fails to adhere to certain standards, only a small portion of the examination may need to be repeated. An example is a study with borderline abnormalities utilized to diagnose Carpal Tunnel Syndrome (CTS) where limb temperature monitoring has not been documented. A recommendation in this case would be to repeat the median sensory NCS under limb temperature control.

Another example of an examination which might not be considered medically useful would be a needle EMG where insufficient muscles were studied to make an accurate diagnosis. In this case, it would be requested that the patient go back to the initial examining physician who would perform testing of the additional requested muscles that would be required to complete the needle EMG.

In some cases, the study might be considered to be not medically useful and it might be concluded a return visit to the same physician would not remedy the situation. Examples of this include unacceptable variation of motor amplitudes, poor quality waveforms, or conclusions which are not supported by the data presented. Recommendation in this situation would be to repeat the entire study by a different physician who is known to perform medically useful EMG & NCS studies.

It is part of One Call Medical’s unique credentialing process to ensure that the physicians entering OCM’s network be made aware of the national guidelines and the OCM’s standards that are required in our report forms.

Through ongoing internal quality review process, all provider’s performance and deficiencies are assessed. When necessary, quality improvement letters are sent out to providers which include reminders regarding their reports and recommendations for improvement.

For more information, or for a free review of any of your EMG & NCS reports, please contact:

Clinical Services
clinical@onecallmedical.com
Fax: 973-257-1363