Medical Policy

The National Government Services Medicare or commonly known as NGS Medicare Contracting Company is a Medicare contracting company. This company has been providing Medicare services to the U.S. government since 1966.


As a Medicare Part A administrator, NGS Medicare treats patients in Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Rhode Island, Vermont, and Wisconsin.

Medical Policies At NGS  

Autonomic Function Testing

The organ controls physiological processes such as blood pressure, heart rate, body temperature, digestion, metabolism, fluid balance, electrolyte balance, sweating, urination, defecation, and sexual response. Without conscious awareness, i.e., autonomously, regulation occurs. In the brain, we have two main sections: sympathetic and parasympathetic. A measure of ANS tests is the change in electrocardiogram (ECG) R-R interval as a result of parasympathetic or sympathetic stimulation. Signs and symptoms of possible autonomic dysfunction are correlated with an objective measure in a clinically useful manner in such a test. In some organs, the sympathetic or parasympathetic system is primarily responsible for regulation, while in others, both systems are allowed to influence function. Sympathetic input increases heart rate, parasympathetic decreases it (e.g., sympathetic input increases heart rate).

B-type Natriuretic Peptide (BNP) Testing

The natriuretic peptide (BNP) is a neurohormone generated predominantly by the left ventricle. During congestive heart failure (CHF), the ventricular volume expands, resulting in pressure overload, which causes such hormones to be secreted. When combined with other clinical information, rapid measurement of BNP can help diagnose CHF, exclude it, and assess its severity in patients with acute dyspnea and begin appropriate treatment. As early as a few days after a coronary event, this test can also be used to assess the long-term risk of cardiovascular events or deaths across the spectrum of acute coronary syndromes.

Prostate Cancer Diagnosis

In the United States, prostate cancer is more likely to develop than any other non-cutaneous malignancy, and it is the third leading cause of cancer-related deaths (after lung and colorectal cancer). An estimated 165,000 men are expected to be diagnosed with prostate cancer in 2018, and around 18% of those men are expected to die from it (2). Despite this, prostate cancer is an extremely heterogeneous disease, whose course can range from indolent to life-threatening. In the 1990s, prostate cancer-specific screenings for prostate-specific antigen (PSA) dramatically reduced the number of patients with metastatic disease at diagnosis (3), reducing mortality from prostate cancer probably, but not definitely (1). Moreover, the overdiagnosis and overtreatment of early-stage and indolent diseases both occurred concurrently (5-9).

A PSA of 4-10ng/mL indicates that about 25% of men have prostate cancer on biopsy. About 20%-50% of the people in this group are lazy, which means the disease would not be a problem if undiagnosed and untreated. According to a recent editorial, “in a biological sense, prostate cancer screening does not cause cancer, but practical standpoint, it does (12).” Meanwhile, the results of three major PSA screening trials involving hundreds of thousands of men, such as the U.S. In the Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PCLO) trial, the European Randomized Study of Screening for Prostate Cancer (ERSPC), and the Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP), the risk-benefit ratio was close (6,13,14). Because screening seemed to be doing more harm than good, the U.S. Preventive Services Task Force (USPSTF) advised against PSA testing in 2012, though this is under reconsideration for men aged 55 to 69 years (10,15).

Botulinum Toxins

There are many types of spastic muscle disorders and excessive muscle contractions that can be treated using botulinum toxins, including dystonias, spasms, and cramps. Pre-synaptic neuromuscular blockade is caused by stopping acetylcholine from being released from nerve endings. When specific muscles are chemically denervated, paresthesia or paralysis is caused, so select muscles can be treated. Over the last two decades, Botulinum toxins have been used for an increasing number of clinical indications. Overactive skeletal muscles (e.g., hemifacial spasms, dystonia, spasticity), smooth muscles (e.g., detrusor overactivity, achalasia), and glands (e.g., sialorrhoea, hyperhidrosis), as well as other conditions, are treated with these agents.