Special EEG Tests

Ambulatory (24-hour) EEG and video-EEG are covered when routine EEG and clinical evaluation are inconclusive and are used to identify, lateralize, or localize seizure foci, differentiate epileptic from non-epileptic events, classify seizures, or assist presurgical localization. Digital EEG analysis is covered as an adjunct when quantitative spike/3D dipole analysis is medically necessary; monitoring is generally expected to be diagnostic within 72 hours outpatient (2–3 days) with longer inpatient/presurgical monitoring (7–10 days) allowed with documentation. Coverage excludes neonates/unattended non-cooperative patients, localization when bilateral foci/rapid generalization are present, and digital analysis for purely psychiatric/behavioral diagnoses or when no spikes exist to analyze.

"Ambulatory (24-hour) EEG monitoring is covered to identify and lateralize/localize a cerebral seizure focus when epilepsy is suspected but not confirmed by history, examination, and routine EEG."