CG-MED-49 Auditory Brainstem Responses (ABRs) and Evoked Otoacoustic Emissions (OAEs) for Hearing Disorders

This policy addresses the use of auditory brainstem response (ABR)—including automated ABR—and evoked otoacoustic emissions (OAE), including OAE followed by ABR, to screen for hearing disorders. Coverage is medically necessary for initial newborn/infant screening; infants under 1 year with an ICU stay of 2 or more days; neonates in the first month with risk exposures (e.g., chemotherapy, exchange-transfusion hyperbilirubinemia, meningitis, culture-positive sepsis); or when infants/children cannot reliably complete behavioral audiometry. ABR/OAE screening is not medically necessary when these criteria are not met.

"Automated auditory brainstem responses (ABR), evoked otoacoustic emissions (OAE), or OAE followed by ABR testing is consideredmedically necessaryto screen for hearing disorders foranyof the followi..."

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