Establishing standards for acceptable waveforms in nerve conduction studies

Introduction: The purpose of this position statement is to clarify what constitutes an acceptable nerve conduction study (NCS) waveform in the practice of electrodiagnostic (EDx) medicine.

Methods: The American Association of Neuromuscular & Electrodiagnostic Medicine convened an expert panel to analyze the typical deficiencies of NCS waveforms seen when performed by unqualified providers and/or providers using substandard equipment and also to describe basic standards that all proper NCS waveforms should meet.

Results: An acceptable NCS waveform should include clearly identifiable polarity, configuration, onset, peak(s), and return to baseline.

Discussion: Only NCSs performed using appropriate EDx equipment and interpreted by trained physicians can accurately measure the speed of nerve conduction and amplitude of the nerve response. If these parameters cannot be clearly identified, then the waveform should be considered substandard and should not be submitted for reimbursement according to the Current Procedural Terminology guidelines of the American Medical Association.