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April 2018; 8 (2) Review

Vestibular evoked myogenic potential testing

Payment policy review for clinicians and payers

Terry D. Fife, Saty Satya-Murti, Robert F. Burkard, John P. Carey
First published March 2, 2018, DOI: https://doi.org/10.1212/CPJ.0000000000000430
Terry D. Fife
Department of Neurology (TDF), Barrow Neurological Institute and University of Arizona College of Medicine, Phoenix; Health Policy Consultant (SS-M), Santa Maria, CA; Department of Rehabilitation Science (RFB), University of Buffalo, NY; and Department of Otolaryngology-Head and Neck Surgery (JPC), Johns Hopkins School of Medicine, Baltimore, MD.
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Saty Satya-Murti
Department of Neurology (TDF), Barrow Neurological Institute and University of Arizona College of Medicine, Phoenix; Health Policy Consultant (SS-M), Santa Maria, CA; Department of Rehabilitation Science (RFB), University of Buffalo, NY; and Department of Otolaryngology-Head and Neck Surgery (JPC), Johns Hopkins School of Medicine, Baltimore, MD.
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Robert F. Burkard
Department of Neurology (TDF), Barrow Neurological Institute and University of Arizona College of Medicine, Phoenix; Health Policy Consultant (SS-M), Santa Maria, CA; Department of Rehabilitation Science (RFB), University of Buffalo, NY; and Department of Otolaryngology-Head and Neck Surgery (JPC), Johns Hopkins School of Medicine, Baltimore, MD.
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John P. Carey
Department of Neurology (TDF), Barrow Neurological Institute and University of Arizona College of Medicine, Phoenix; Health Policy Consultant (SS-M), Santa Maria, CA; Department of Rehabilitation Science (RFB), University of Buffalo, NY; and Department of Otolaryngology-Head and Neck Surgery (JPC), Johns Hopkins School of Medicine, Baltimore, MD.
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Citation
Vestibular evoked myogenic potential testing
Payment policy review for clinicians and payers
Terry D. Fife, Saty Satya-Murti, Robert F. Burkard, John P. Carey
Neurol Clin Pract Apr 2018, 8 (2) 129-134; DOI: 10.1212/CPJ.0000000000000430

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Abstract

Purpose of review A recent American Academy of Neurology Evidence-Based Practice Guideline on vestibular myogenic evoked potential (VEMP) testing has described superior canal dehiscence syndrome (SCDS) and evaluated the merits of VEMP in its diagnosis. SCDS is an uncommon but now well-recognized cause of dizziness and auditory symptoms. This article familiarizes health care providers with this syndrome and the utility and shortcomings of VEMP as a diagnostic test and also explores payment policies for VEMP.

Recent findings In carefully selected patients with documented history compatible with the SCDS, both high-resolution temporal bone CT scan and VEMP are valuable aids for diagnosis. Payers might be unfamiliar with both this syndrome and VEMP testing.

Summary It is important to raise awareness of VEMP and its possible indications and the rationale for coverage of VEMP testing. Payers may not be readily receptive to VEMP coverage if this test is used in an undifferentiated manner for all common vestibular and auditory symptoms.

Footnotes

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • Received September 4, 2017.
  • Accepted November 28, 2017.
  • © 2018 American Academy of Neurology
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