Intraoperative Neurophysiological Testing

Intraoperative neurophysiological testing is covered when used to identify or prevent neurologic injury during surgeries that put the brain, spinal cord, cranial or major peripheral nerves, or related vascular territories at risk (e.g., aortic arch/thoracic aorta procedures, brain and spinal tumor resections, spinal instrumentation, cranial nerve and certain thyroid surgeries). Coverage requires an operating-surgeon order, physician supervision by a non‑surgeon MD/DO with undivided attention, a continuously attending trained technologist (preferably credentialed), adequate equipment and channel capacity (>=8 channels; >=16 if EEG), and adherence to real-time communication and documentation standards; remote monitoring is allowed only if technical and communication criteria are met. Monitoring is not reasonable when there is no potential for neural damage, is limited to specified places of service (hospital or ASC), and Medicare will not reimburse simultaneous monitoring of multiple patients or 'incident to' hospital services.