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Medical Policy Updates

Notification of Policy Revisions Effective July 28, 2017 (Posted May 26, 2017)

Medical Guidelines Reason for Update
Vestibular Function Testing "Notification" New policy developed. Vestibular function testing with electronystagography/videonystagmography, caloric test, and rotational chair test for suspected vestibular dysfunction is considered medically necessary when criteria are met. Vestibular evoked myogenic potentials are considered investigational. Vestibular function testing for benign paroxysmal positional vertigo is not medically necessary. Notification given 5/26/2017 for effective date 7/28/2017.