Triple-S will consider for payment studies of evoked potentials when they are performed with the purpose of:
• Demonstrating abnormality in the functioning of the sensory nervous system in patients with a questionable clinical presentation.
• Help define the anatomical distribution of the disease or condition in question.
• Objectively monitor changes over time.
• Determine the treatment to be instituted and/or evaluate the efficacy of the same.
Indications for its use
a) Visual evoked potentials:
• Diagnosis and monitoring of multiple sclerosis (in acute or chronic phase).
• Location of the cause of defects in Visual fields, when it is not explained by lesions seen on CT or MRI.
• Metabolic disorders or infectious diseases.
b) Auditory evoked potentials:
• Evaluation of function of the brain stem in acquired metabolic disorders.
• To assess the functional recovery after surgical removal of lesion(s) which compresses the brain stem.
• Location of the cause of neurological deficit that is not explainable by identified lesions by CT or MRI.
• Diagnosis and monitoring of demyelinating and degenerative diseases affecting brain stem function (multiple sclerosis, myelinolytic pontinocerebral, olivopontocerebellar degeneration, etc.)
• Diagnosis of lesions in the auditory system.
• Along with the EEG, for the evaluation of irreversible coma or brain death.
• Intraoperative monitoring of brain stem auditory evoked potentials during a procedure of the spinal cord, intracranial or vascular.
• Confirmation of the diagnosis of acoustic neuroma.
• Determine of the type and severity of hearing problems or determine the degree of development of the nerves of the auditory system in children under five years of age.
c) Somatosensory evoked potential:
• To validate and quantify any impairment to justify surgical intervention in patients who are unconscious, who have suffered trauma to the spinal cord and that show structural damage of the somatosensory system and those who are candidates for surgery of the spinal cord.
• Intraoperative monitoring during surgery of the vascular, intracranial or spinal cord.
• Diagnosis and management of specific neurological conditions that involve somatosensory system, such as multiple sclerosis and Pelizaeus-Merzbacher disease.
Triple-S shall not consider for payment studies done in the following situations:
a) Intraoperative:
1. Visual evoked potentials
2. Motor evoked potentials
b) Auditory evoked potentials for the determination of gestational age during pregnancy.
c) Somatosensory evoked potential:
1. In patients with craniocerebral trauma – not in coma, because it does not alter the management of patients.
2. In the diagnosis or management of ALS, because it is not specific for diagnosis or alters patient management.
3. In the diagnosis or management of metabolic disorders, so do not change managing these.
