Evoked Potential Studies

SEPs/DSEPs are medically necessary only to (1) assess decline in unconscious spinal cord injury patients with specific structural somatosensory damage who are candidates for emergency spinal surgery, (2) evaluate acute anoxic encephalopathy within 3 days of the event, (3) evaluate suspected brain death, and (4) help establish MS when suggestive neurologic symptoms are accompanied by ≥1 other objective finding (MRI plaques, clinical lesions, or positive CSF oligoclonal bands/increased IgG index). All other uses of SEPs/DSEPs, VEPs (including routine/infant screening), and comprehensive BAERs are considered experimental/investigational (BAER intraoperative monitoring allowed per CPB 0697), and for newborn/infant screening only limited auditory evoked potentials or limited OAE are medically necessary while comprehensive ABR/OAE for initial screening is not.

"For neonatal or infant hearing screening: documentation of the use of limited ABR or limited OAE for screening; if screening fails, documentation that referral for comprehensive ABR/OAE occurred"