CurrentUnitedHealthcarePolicy CSO23NMB

Computerized Dynamic Posturography (for New Mexico Only)

UnitedHealthcare medical policy for the state of New Mexico governing coverage of computerized dynamic posturography (CDP) testing (balance board/posturography) including definitions, clinical evidence, and applicable CPT codes. It states the policy's applicability is limited to New Mexico and provides coding and supporting evidence references.

Policy Summary

PayerUnitedHealthcare

PolicyComputerized Dynamic Posturography (for New Mexico Only)

Policy CodePolicy CSO23NMB

Change TypeSupporting information updated

Effective DateApr 1, 2025

Next Review Date

Key ActionClaims for computerized dynamic posturography (CDP) are considered unproven and not medically necessary for evaluating any condition in New Mexico; such services are at risk for denial based on this policy.

POLICY UPDATE CHANGES

04/01/2025 revision archived previous policy version CSO23NMA; policy statement that CDP is unproven/not medically necessary remains.

2CPT codes listed

insufficientEvidence strength

NM onlyGeographic scope

Coverage Summary

Policy Number: CSO23NMB. This UnitedHealthcare medical policy applies only to the state of New Mexico and is effective April 1, 2025. Policy statement: Computerized dynamic posturography (CDP) testing is unproven and not medically necessary for evaluating any condition (including but not limited to balance disorders) due to insufficient evidence of efficacy.

Medical Necessity Determination

Medically Necessary Determination

Policy statement:

ALL of the following

This Medical Policy only applies to the state of New Mexico.
Computerized dynamic posturography (CDP) testing is unproven and not medically necessary for evaluating any condition including but not limited to balance disorders due to insufficient evidence of efficacy.

Not Medically Necessary / Unproven Services

UnitedHealthcare's stance for New Mexico is that CDP is considered unproven and not medically necessary for evaluating any condition. The policy explicitly limits application to New Mexico only and cites insufficient evidence of diagnostic performance and clinical utility to support use of CDP for vestibular or other disorders.

Not Medically Necessary

Not Medically Necessary Conclusion: Computerized dynamic posturography (CDP) testing is unproven and not medically necessary for evaluating any condition including but not limited to balance disorders due to insufficient evidence of efficacy.

Coding

Applicable CPT codes (listed for reference)CPT

92548	Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (i.e. eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report.
92549	Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (i.e. eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (MCT) and adaptation test (ADT).

Provider Actions & Billing Impact

Denial Risk

CDP considered not medically necessary in New Mexico

Claims for computerized dynamic posturography (CDP) are considered unproven and not medically necessary for evaluating any condition in New Mexico; such services are at risk for denial based on this policy.

92548 — claims for this CPT are at risk for denial
92549 — claims for this CPT are at risk for denial

Documentation Required

Reference federal/state/contractual requirements

When deciding coverage, providers must reference federal, state, or contractual requirements as they may override this standard policy; the policy is informational and not a guarantee of coverage.

Background

Computerized dynamic posturography (CDP) uses a moving/platform device to evaluate a patient's ability to maintain balance by manipulating vision, proprioception, and vestibular inputs. It has been used to attempt to isolate vestibular causes of imbalance and as part of vestibular rehabilitation protocols. Standard vestibular tests referenced as alternatives include electronystagmography and rotational chair testing.

Clinical Evidence Summary

Evidence summarized in the policy indicates overall insufficient or weak support for CDP. A Hayes evolving evidence review (2021, updated 2023) found no studies that met inclusion criteria and concluded there was insufficient evidence of diagnostic performance or clinical utility. A single small randomized trial (David & Shahnaz, 2024; n=37) comparing a rehabilitative CDP protocol (computerized vestibular retraining therapy, CVRT) to a home exercise program reported improvements in some sensory organization test (SOT) composite and dynamic equilibrium scores with CVRT but had limitations (small sample, randomization error, control group differences, differential withdrawal) and uncertain clinical utility. Multiple small observational and validation studies across conditions (PD, MS, TBI, CSD, ASD) report reliability or group differences but are limited by small sample sizes, study design, and do not demonstrate demonstrated clinical utility for guiding care.

Evidence

Hayes Evolving Evidence Review (2021, updated 2023)No studies met inclusion criteria; weak support based on expert opinion; insufficient evidence of diagnostic performance or clinical utility.

Randomized trial (David & Shahnaz, 2024)Small RCT (n=37) comparing CVRT vs home exercise showed SOT composite and dynamic equilibrium score improvements with CVRT but limitations and uncertain clinical utility.

Multiple small observational studiesVarious small studies (PD, MS, TBI, CSD, ASD) show reliability or differences but are limited by small sample sizes and do not demonstrate clinical utility.