Setup – P8 Median-Ulnar Sensory NCS

Electrode placement (use the BAR electrode)

• Two sites
  • Median nerve site
    • E1 (black):  Along the middle of the forearm (in line with the median nerve)
    • E2 (red):  3-4cm proximal to E1.
  • Ulnar nerve site
    • E1 (black):  Along the medial forearm (in line with the ulnar nerve)
    • E2 (red):  3-4cm proximal to E1.
• Ground:  Dorsum of hand (for both)

Stimulation site

• Two sites (the stimulating black cathode should be at a line across the middle of the palm, and then the electrode pickups set accordingly)
  • Median nerve site
    • (-) Cathode (black):  8-cm distal to E1.  Note: Make the 8-cm line to the middle of the palm.
    • (+) Anode (red):  distal
  • Ulnar nerve site
    • (-) Cathode (black):  8-cm distal to the ulnar E1, along the palmar surface of the medial palm, NOT the knife edge of the palm.
    • (+) Anode (red):  distal (in line with the ulnar distribution)

      

Additional Information

• Type of stimulation = Antidromic
• The black E1 should be more distal than the red E2 for this test.
• One of the three studies for the combined sensory index (CSI): numb thumb, split ring, P8
• CPT codes for nerve conduction studies
  • 95900 Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study
  • 95903 Nerve conduction, amplitude and latency/velocity study, each nerve; motor with F-wave study
  • 95904 Nerve conduction, amplitude and latency/velocity study, each nerve; motor with F-wave study, each nerve; sensory
  • 95934 H-reflex, amplitude and latency study; record gastrocnemius/soleus muscle
  • 95936 Record muscle other than gastrocnemius/soleus muscle