Tilt Table Testing

This policy covers tilt‑table testing — a motorized, laboratory‑grade upright tilt test — for evaluation of syncope and orthostatic intolerance (including suspected neurocardiogenic/vasovagal syncope), differentiation of convulsive syncope from seizure, assessment in patients with or without structural cardiovascular disease when other causes have been excluded, and to help determine pacemaker candidacy when a cardioinhibitory/bradycardic response is demonstrated. Major requirements and limitations: the test must be performed on a motorized tilt table in a cardiac cath/electrophysiology setting (0°→60° in <10 seconds, proper restraints, ability to hold 60°); it is not sufficiently sensitive or specific to exclude life‑threatening cardiac causes, and is considered investigational for recurrent dizziness/presyncope, peripheral neuropathies/dysautonomias, chronic fatigue syndrome, recurrent vertigo/TIA, routine therapy follow‑up, and other indications outside the stated covered uses.