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
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
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.