Additionally, many studies have reported the usefulness of this technique, and recommended its use for the diagnosis of psychogenic seizures.Īn evidence report prepared for AHRQ (Ross et al, 2001) concluded that EEG video monitoring was useful for diagnosis of epilepsy if the EEG, CT, and MRI are non-diagnostic, and in diagnosis in very young children, in patients with poorly characterized seizure types, and in those with suspected psychogenic seizures. The American Epilepsy Society has stated that this technique is the method of choice for the evaluation of intractable and/or undiagnosed seizure disorders. Furthermore, the American EEG Society has noted that this procedure is widely regarded as safe and effective for evaluating seizures disorders. The Agency for Health Care Policy and Research has stated that information provided by video electroencephalographic (EEG) monitoring has improved patient outcome by permitting accurate diagnoses and modified therapy. See also CPB 0221 - Quantitative EEG (Brain Mapping) and CPB 0289 - Grid Monitoring and Intraoperative Electroencephalography. An acute level of care is not considered medically necessary for many persons requiring video EEG monitoring.įor home video EEG monitoring, see CPB 0425 - Ambulatory Electroencephalography.įor video EEG monitoring that is not attended and is performed in a healthcare facility, see CPB 0425 - Ambulatory Electroencephalography. Note: The medically necessary level of care a member requires should be addressed individually according to the member's clinical needs. The member requires medication adjustments requiring ongoing monitoring (evaluating response) that cannot be safely performed on an outpatient basis. The member has experienced events so infrequent that there is a significant likelihood that they would not be detected within one week of monitoring orĪn extended stay is necessary for care for an adverse event (eg, postictal psychosis, falls, respiratory failure, status epilepticus) or
Prolonged (greater than 7 days) attended EEG video monitoring in a healthcare facility is considered medically necessary for the following indications: See also CPB 0394 - Epilepsy Surgery.Īetna considers attended EEG video monitoring for driving clearance not medically necessary treatment of disease.Īetna considers attended EEG video monitoring experimental and investigational for all other indications (e.g., assessment of obstructive sleep apnea, amyotrophic lateral sclerosis (ALS), cardiac arrest, chronic fatigue, coma, headache, and assessment of the effectiveness of drug treatment in epilepsies, diagnosis of brain death, and prognosis of cardiac arrest treated with hypothermia, and newborns with hypoxic-ischemic encephalopathy treated with hypothermia not an all inclusive list) because its effectiveness for these indications has not been established.įootnote 1* Requirements for a standard EEG and neurologic examination are waived for medically necessary video EEG performed in an intensive care unit (ICU).
In these cases, response to therapy can be assessed using standard EEG monitoring or ambulatory EEG monitoring.Īetna considers attended EEG video monitoring in a healthcare facility medically necessary for identification and localization of a seizure focus in persons with intractable epilepsy who are being considered for surgery. Note: Once the cause of seizures and specific type of epilepsy has been established, continued video EEG monitoring (e.g., for monitoring response to therapy or titrating medication dosages in older children and adults) is considered not medically necessary.
To establish the specific type of epilepsy in poorly characterized seizure types where such characterization is medically necessary to select the most appropriate therapeutic regimen or.
To establish the first diagnosis of a seizure disorder or