Back to dashboard
All PlansCoverageMedium impact

Diagnostic Uses of Sensory Evoked Potentials (SEPs)

Blue Cross & Blue Shield of Mississippi·MS · ENT (Ear, Nose & Throat), Neurology, Radiology +2 more·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

This is a new comprehensive policy defining medical necessity criteria for three types of evoked potential tests: Visual (CPT 95930), Auditory (CPT 92650-92653), and Somatosensory (CPT 95925-95927, 95938). The policy includes extensive ICD-10 code updates effective October 1, 2025, and explicitly lists conditions where these tests are NOT covered.

Action Required

Action needed
By October 1, 2025: Billing team must update system with new ICD-10 codes for multiple sclerosis (G35 will be deleted, replaced with specific G35.A through G35.D codes). Verify medical necessity documentation matches approved indications before billing evoked potential tests. Train staff to recognize non-covered uses including head injury evaluations and ALS diagnosis. Update encounter forms with covered diagnosis codes.

Affected Billing Codes

95930
92650
92651
92652
92653
95925
95926
95927
95938
G35
G35.A
G35.B0
G35.B1
G35.B2
G35.C0
G35.C1
G35.C2
G35.D
H53.40
H53.431
H53.439
H53.451
H53.459
H53.461
H53.469
H53.47
E00.0
E35
E40
C71.7
C79.31
D33.0
D33.2
D43.0
D43.4
D49.6
I67.89
I67.858
R29.818
R29.898
R29.90
R29.91
G23.0
G23.9
G37.1
G37.2
G37.81
G37.89
R40.0
R40.1
S14.0XXA
S14.159S
S24.0XXA
S24.159S
S34.01XA
S34.139S
S34.3XXA
S34.3XXS
E75.27
E75.23
E75.25
E75.29
S02.0XXA
S02.42XS
S02.600A
S02.92XS
S06.330A
S06.339S
G12.21
G12.25