Intraoperative Neurophysiologic Monitoring (sensory-evoked potentials, motor-evoked potentials, EEG monitoring) "Notification"
Evidence based guideline converted to corporate medical policy. Added Related Policy: Electrodiagnostic Studies to the Description section. "Intraoperative monitoring, which includes somatosensory-evoked potentials, motor-evoked potentials using transcranial electrical stimulation, brainstem auditory-evoked potentials, EMG of cranial nerves, EEG, and electrocorticography (ECoG), may be considered medically necessary during spinal, intracranial, or vascular procedures." "Intraoperative monitoring of visual-evoked potentials is considered investigational." "Due to the lack of FDA approval, intraoperative monitoring of motor-evoked potentials using transcranial magnetic stimulation is considered investigational. Intraoperative EMG and nerve conduction velocity monitoring during surgery on the peripheral nerves is considered not medically necessary." "Intraoperative neurophysiology monitoring is considered not medically necessary when performed outside the 2009 American Clinical Neurophysiology Society recommended standards as stated in the Policy Guidelines." "Note: A physician can monitor NO more than three cases simultaneously." Policy Guidelines updated. Added the following codes to the Billing/Coding section; 51784, 51785, 95961, 95962, and 95829. Referenced Code Bundling Rules Not Addressed in ClaimCheck® or Correct Coding Initiative in the Billing/Coding section. References added. Senior Medical Director review 2/4/2014. Notification given 2/11/2014. Policy effective 4/15/2014.