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TRICARE Policy Manual 6010.60-M, April 1, 2015
Medicine
Chapter 7
Section 15.2
Sensory Evoked Potentials (SEP)
Issue Date:  September 23, 1991
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
Revision:  
1.0  CPT PROCEDURE CODES
92585, 95925 - 95930
2.0  DESCRIPTION
SEPs are electrical waves that are generated by the response of sensory neurons to stimuli. Changes in the electrical waves are averaged by a computer and then interpreted by a physician. Computer-averaged SEPs can be used to assist the diagnosis of certain neuropathologic states or to provide information for treatment management. Intraoperative monitoring of sensory evoked potentials is used during orthopedic or neurologic surgical procedures to reduce surgically induced morbidity and/or to monitor the level of anesthesia.
3.0  POLICY
Visual, auditory, and somatosensory evoked potential recordings that are medically necessary to diagnose, evaluate, assess recovery of brainstem function, measure the type and extent of hearing impairment, and to assess somatosensory function in unconscious patients or to supplement the Electroencephalogram (EEG) in evaluating brain death or irreversibility of coma are covered.
4.0  EXCLUSION
Intraoperative monitoring of SEPs to define conceptional or gestational age in pre-term infants is unproven.
5.0  EFFECTIVE DATE
May 18, 1993.
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