Somatosensory Testing

Short-latency somatosensory evoked potentials (SEPs) are covered when clinical history, neurologic exam, and supporting diagnostic tests indicate a suspected lesion of the central somatosensory pathways (brain, brainstem, or spinal cord), and for intraoperative monitoring during spinal surgeries with risk of additional nerve or cord injury. SEPs are not generally indicated for most peripheral neuropathies (where EMG/NCS suffice) and are not anticipated to be necessary for routine cervical or lumbar root decompression procedures. Documentation must include detailed history, neurologic exam, and supporting imaging/EMG/NCS results, and interpretation/supervision must be by appropriately trained providers; beneficiaries must be notified in writing if the provider believes Medicare coverage is unlikely.

"Short-latency SEPs are medically reasonable and necessary when clinical history and neurologic examination suggest a lesion of the central somatosensory pathways (brain, brainstem, or spinal cord)."