Electroencephalographic (EEG) Video Monitoring

Attended EEG video monitoring is medically necessary when the diagnosis remains uncertain after a neurological exam and standard EEG within the past 90 days and non‑neurological causes are excluded, specifically to differentiate epileptic vs psychogenic events, establish a first seizure diagnosis, define epilepsy type when required to select therapy, or diagnose/evaluate epilepsy in very young children (≤3 years), children with severe cognitive deficits, or noncommunicative older adults. It is not medically necessary once the seizure cause/type is established (including routine response monitoring or medication titration), is not covered for driving clearance, and is considered investigational/not covered for other indications (including assessment of drug treatment effectiveness).

"When pre-surgical localization is the indication, documentation that the person has intractable epilepsy and is being considered for surgery (see CPB 0394 - Epilepsy Surgery for related requirements)."