CurrentBlue Cross Blue Shield - Rhode IslandPolicy N/A

Computerized Dynamic Posturography (Coverage Criteria)

This policy governs coverage and medical necessity determinations for computerized dynamic posturography testing for balance assessment under Blue Cross Blue Shield - Rhode Island products.

Policy Summary

PayerBlue Cross Blue Shield - Rhode Island

PolicyComputerized Dynamic Posturography (Coverage Criteria)

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionVerify member-specific benefits and eligibility with the subscriber agreement or provider call center prior to service.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

92548CPT code not covered

Not coveredBlueCHiP for Medicare stance

Not medically necessaryCommercial products stance

Not requiredPrior authorization

Coverage Criteria for Computerized Dynamic Posturography

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BlueCHiP for Medicare: Dynamic posturography is considered not covered for BlueCHiP for Medicare because the evidence is insufficient to determine the effects of the technology on health outcomes.

Commercial products: Dynamic posturography is considered not medically necessary for commercial products because there are no studies demonstrating the clinical utility of the test that would lead to changes in management that improve outcomes; the evidence is insufficient to determine the effects of the technology on health outcomes.

For commercial products, computerized dynamic posturography is considered not medically necessary. The policy rationale states there are no studies demonstrating the clinical utility of the test that would lead to management changes that improve outcomes (for example, symptoms or function). Because such evidence is lacking, the technology’s effect on health outcomes is insufficient to support coverage.

Dynamic posturography is not medically necessary for commercial products due to insufficient evidence. Available studies are limited to technical performance, cross-sectional comparisons, and retrospective case series and do not show that test results change clinical management in ways that improve patient outcomes. In particular, there is a lack of established reference standards and insufficient data on test performance for clinically important questions (for example, identifying patients at risk of falls), so evidence does not support medical necessity for routine use.

Provider Actions and Billing Impact

Prior Authorization

Prior authorization is not required or applicable for dynamic posturography. Coverage determinations and member-specific benefit limits still apply.

Note

Verify Benefits and Eligibility

Verify member-specific benefits, eligibility, and any applicable subscriber agreement prior to scheduling or performing services. Contact the provider call center for questions about coverage for an individual member.

Denial Risk

Denial Risk for CPT 92548

Claims for CPT 92548 (Computerized dynamic posturography) are at risk of denial because dynamic posturography is considered not medically necessary for Commercial members and not covered for BlueCHiP for Medicare.

CPT 92548

Documentation Required

Provider Operational Note

Operational note: Do not bill members for services determined to be not medically necessary unless the member has been informed in advance and has agreed in writing to accept financial responsibility. Refer to participation and subscriber agreements for applicable provisions.

Background

Computerized dynamic posturography is a quantitative balance assessment that manipulates the support surface and visual surround to evaluate how vestibular, visual, and somatosensory inputs contribute to postural control. Testing typically uses a force platform and a series of standardized conditions (including sway-referenced support and/or visual surrounds) to measure center-of-mass movement and sensory organization for balance. The test is intended to assess functional balance control rather than to localize a specific lesion.

Definitions

Dynamic posturography definition — key attributes

Test typeComputerized dynamic posturography (a computerized balance test using a force platform and visual surround)

Key featuresPatient stands on an enclosed force platform while wearing a safety harness; center-of-mass movement is measured to quantify balance control

Sway-referenced platformThe support surface can be fixed or sway-referenced — sway-referencing means the platform is instantaneously adjusted to coincide with body sway to cancel accurate somatosensory feedback

Visual surround manipulationVisual field can be fixed, absent (eyes closed), or sway-referenced to alter visual input and assess its contribution to postural control

Purpose and limitationsDesigned to evaluate sensory organization (vestibular, visual, somatosensory contributions) for postural control and quantify functional balance, but not to localize a lesion or diagnose a specific balance disorder

Revision History

2019-06publication

Policy published in Provider Update, June 2019.

2018-09publication

Policy referenced in Provider Update, September 2018.

2018-01publication

Policy referenced in Provider Update, January 2018.

2017-01publication

Policy referenced in Provider Update, January 2017.

2015-08publicationLatest

Policy referenced in Provider Update, August 2015.