Key Takeaway
Jason's 2014 PF-NCT commentary, with the Tahir decision and a distinction between historical litigation views and current coding or clinical advice.
This article is part of our ongoing medical necessity coverage, with 170 published articles analyzing medical necessity issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Jason’s 2014 note about PF-NCT includes a case he remembers losing. That case was Tahir v Progressive, decided in 2006. The published opinion identifies him as defense counsel and records judgments for the provider in two consolidated trials.
Historical note: The Tahir decision (2006) rejected the two defenses tried there; it did not resolve today’s PF-NCT billing codes, validate the device described below or prescribe a clinical testing sequence.
Last reviewed: September 2026.
Tahir v Progressive concerned current-perception or sensory nerve-conduction threshold testing. The Civil Court rejected Medicare nonpayment as a sufficient reason by itself to deny these no-fault claims. It also rejected the attempt to treat this medical-necessity dispute as a coverage defense by labeling the procedure fraudulent.
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The defense expert had not addressed the patients’ individual medical circumstances. That evidentiary failure did not establish the accuracy of every device or the right billing code. Nor does the opinion verify that the later PF-NCT device described below is identical to the testing litigated in 2006.
The preserved passage is a record of Jason’s litigation views in October 2014. A current claim needs service-date coding and medical review; the old code suggestions and comparisons with EMG/NCV are not instructions for billing or choosing care.
Jason’s original comment
Jason’s October 2014 discussion follows unchanged as an archive passage, not current coding or clinical advice. The suggested codes, device description and views about which tests should be used have not been clinically or technically revalidated. His reference to losing Tahir is supported by the 2006 opinion, although his phrase “10 years ago” was approximate.
One of the “tests” that we see a lot of are on the run of the mill CPT, V-SNCT, PF-NCT. Of course, if you ask a Claimant “Have you ever had a CPT, V-SNCT, PF-NCT test?”, they will look at you with googly eyes. But when you show them a pen and say “you know, the test where this pen like device is connected to a computer and areas of your body are touched”, then they say, “oh I remember that.” Then you ask them, did anyone tell you the results? Nope.
This testing has three defenses. The first is the “fraud” defense. I lost that one 10 years ago, but had fun trying (Tahir v. Progressive). Nothing more will be said as the testing (even to its most vocal critics) has some valid purposes when dealing with diabetic neuropathy.
The second defense I am now seeing en vogue is the “coding” defense. Should the test be billed at 95903, 95999 or a T-3 code? Different people have different answers. My vote is for a T-3 code. This has had success at arbitrations. I would be interested to see what the Appellate Term says (when a proper foundation is adduced at either trial or on motion practice). The 95903 code appears to be from an instruction manual that the end user gets when they purchase the Axion-II machine (or its predecessors).
The new PF-NCT purports not to be entirely subjective as there is a potentiameter. Still, the patient is in control as (s) he is told to explain when they feel pain during the performance of the test, hence the subjective component. Thus, the potentiometer is supposed to objectify the subjective component of the test.
The third defense is based upon the EMG/NCV test occurring within weeks or a few months of the PF-NCT test during the patient’s treatment path. The theory, and I think it is quite valid, is pick your test. Either perform the EMG/NCV test (the so-called “gold-standard”) or the PF-NCT test, but not both. The detractors of this argument will say the the PF-NCT is more sensitive to A- fibers and C-Fibers (pain receptors) that the EMG/NCV does not address. But isn’t an EMG/NCV when appropriately performed with an examination sufficient to obtain all of the objective data? Many time, the EMG/NCV may also be overkill.
Also, if you take a pin and prick various parts of the body (waiting to elicit a response from the patient), shouldn’t this be sufficient to determine the extent of the pain fibers and to allow the clinician to accurately determine where there is sensitivity.
Connect to the Encyclopedia
Start with the medical-necessity and peer-review topic hub.
- Mollo: competing MUA experts at trial
- Radiology Today: peer reports and live trial testimony
- Throgs Neck: inadequate opposition to an IME-based motion
- Forest Drugs: an affirmation that did not answer the IME
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Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
Medical Necessity Disputes in No-Fault Insurance
Medical necessity is the most common basis for no-fault claim denials in New York. Insurers hire peer reviewers to opine that treatment was not medically necessary, shifting the burden to providers and claimants to demonstrate otherwise. The legal standards for establishing and rebutting medical necessity — including the sufficiency of peer review reports, the qualifications of reviewing physicians, and the evidentiary burdens at arbitration and trial — are the subject of extensive case law. These articles provide detailed analysis of medical necessity litigation strategies and court decisions.
170 published articles in Medical Necessity
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Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
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