Dynamic Posturography
Customize your policy alerts
Sign up for all blue cross blue shield - kansas policy alerts
Know when blue cross blue shield - kansas releases new policies or updates existing guidance.
Monitor payer policy activity
This policy governs the coverage stance and evidentiary rationale for computerized dynamic posturography as a diagnostic adjunct for individuals with suspected balance disorders under Blue Cross and Blue Shield of Kansas.
No material clinical or coverage changes in this revision.
Coverage Determinations and Rationale
inv-01: Coverage conditions (policy narrative)
Covered when ALL of the following are met:
See Clinical Context and Population descriptions.
Documentation of the initial evaluation is required before consideration of further testing.
Intended clinical role: to inform decisions about further diagnostic workup or immediate treatment.
Studies of clinical validity should report on the accuracy of the marketed version and include suitable reference standards when available.
This policy considers dynamic posturography experimental/investigational based on available evidence and therefore not routinely covered; refer to member contract benefits for individual coverage determinations.
inv-02: Clinical validity and utility
Summary of evidence and coverage implications:
Direct evidence would require studies comparing outcomes with and without test-directed management; none were identified.
Absence of a criterion standard limits ability to define clinical validity.
Retrospective and small studies have described use of posturography in assessment or as outcome measures, but contribution to management decisions is unclear and no controlled evidence shows improved outcomes.
Per this policy, dynamic posturography is considered experimental / investigational and is therefore excluded from coverage unless the member’s contract benefits in effect at the time of service specify otherwise. Providers should verify individual member contract provisions with Blue Cross and Blue Shield of Kansas to determine coverage for a particular case.
CPT code 92700 (unlisted otorhinolaryngological service) will be denied as experimental/investigational if billed specifically for the following vestibular tests: Vestibular Evoked Myogenic Potentials (VEMP), Video Head Impulse Test (vHIT), Saccades Test, and Gans Sensory Organization Test (SOP).
This segment does not list additional explicit exclusions beyond those stated; if providers have questions about coverage or need clarification for a specific patient, they should contact Blue Cross and Blue Shield of Kansas customer service or their professional/institutional relations representative.
The policy finds insufficient evidence demonstrating the clinical validity and clinical utility of dynamic posturography to diagnose specific balance disorders or to show that its use leads to improved health outcomes. No studies were identified that define sensitivity and specificity against a criterion standard, and direct evidence that use of the test to guide management improves outcomes is lacking.
Because randomized or nonrandomized controlled trials comparing management with and without computerized dynamic posturography were not identified, there is no direct evidence that using CDP to guide clinical management improves patient health outcomes. Consequently, the clinical utility of CDP for diagnostic decision-making or for directing therapy is unproven.
Procedure and Regulatory Codes
| LXV | FDA product code for dynamic posturography devices |
| 92548 | Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions, including interpretation and report |
| 92549 | Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions, including interpretation and report; with motor control test (MCT) and adaptation test (ADT) |
| 92700 | Unlisted otorhinolaryngological service or procedure |
| 92700 | Will be denied as experimental/investigational if billed for Vestibular Evoked Myogenic Potentials (VEMP), Video Head Impulse Test (vHIT), Saccades Test, Gans Sensory Organization Test (SOP) |
What Providers Must Do / Watch For
Verify Member Benefits
Verify member benefits before providing services. Coverage for dynamic posturography depends on the member's contract and any applicable state or federal mandates; contact Blue Cross and Blue Shield of Kansas Customer Service to confirm benefits and any coverage limitations.
- Contact BCBSKS Customer Service to verify member contract benefits and coverage prior to authorization or service.
Prior Authorization / Coding Note
The following procedure codes are listed in the Coding section and are subject to the Policy. These codes are medically necessary ONLY if the procedure is performed in accordance with the Policy section of this document.
Denial Risk for 92700 on Specific Vestibular Tests
CPT code 92700 will be denied as experimental/investigational when billed for specific vestibular tests. Do not bill 92700 for these tests or expect coverage under this policy.
- 92700 will be denied if billed for: Vestibular Evoked Myogenic Potentials (VEMP); Video Head Impulse Test (vHIT); Saccades Test; Gans Sensory Organization Test (SOP).
Pre-test Clinical Evaluation Documentation
Document that the patient presented with balance dysfunction or dizziness and that an initial clinical evaluation was performed prior to dynamic posturography. The initial evaluation should include history, clinical examination, appropriate vital signs, orthostatic blood pressure measurements, and any basic evaluations directed by symptoms (e.g., electrocardiogram).
- Record presenting symptoms (balance dysfunction or dizziness).
- Document clinical exam, history, vital signs, orthostatic blood pressures, and any symptom-directed basic evaluations prior to ordering dynamic posturography.
Medical Necessity Conditional on Policy Compliance
Medical necessity for the listed CPT codes is conditional on compliance with the Policy section. Services will be considered medically necessary only when performed according to the policy criteria; otherwise they may be non-covered or denied.
Provider Contact for Coverage Questions
For questions about coverage, prior authorization, or potential denials, contact Blue Cross and Blue Shield of Kansas customer service or your professional/institutional relations representative.
- Reach out to BCBSKS Customer Service for coverage determinations and to confirm any prior authorization requirements.
- Contact your professional or institutional relations representative for assistance with policy interpretation or claims issues.
Clinical Background and Scope
Maintenance of balance requires integration of vestibular, visual, proprioceptive, and central processing; impairment of these systems increases fall risk, particularly in older adults. Dynamic posturography (also called computerized dynamic posturography) attempts to quantify functional balance by altering platform and visual inputs to isolate sensory contributions to postural control, but it does not localize lesion site and its role in changing management is uncertain. Blue Cross and Blue Shield of Kansas will continue to monitor the literature and encourages providers to consult the policy and contact BCBSKS with questions about coverage.
Key Terms and Test Descriptions
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.