Electronystagmography (ENG) involves the electrical recording of involuntary eye movements. It is usually performed in the evaluation of dizziness, vertigo, or balance dysfunction. Metal electrodes are placed above, beside, and below each eye to detect eye movements.

Videonystagmography (VNG) provides vestibular examinations and performs electronystagmography without the use of electrodes. Such non-invasive video systems record, analyze, and report eye movements using video imaging technology. VNG requires the individual to wear a pair of infrared goggles and allows recording of actual video images of eye movement in real time.

Electronystagmography (ENG) may be considered medically necessary for the following indication:

• Evaluation of individuals with symptoms of vestibular disorders (e.g., dizziness, vertigo, disequilibrium or imbalance)

Videonystagmography (VNG) may be considered medically necessary for the following indication:

• Evaluation of individuals with symptoms of vestibular disorders (e.g., dizziness, vertigo, disequilibrium or imbalance)

ENG and VNG for all other conditions are considered not medically necessary.

Procedure Codes

ANY ONE of the following procedures represents ENG or VNG:

• Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording; positional nystagmus test, minimum of four (4) positions, with recording; optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording; and oscillating tracking test, with recording; or
• Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording; or
• Positional nystagmus test, minimum of four (4) positions, with recording; or
• Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes four [4] tests), with recording; or
• Optokinetic nystagmus test, bidirectional, foveal, or peripheral stimulation, with recording; or
• Oscillating tracking test, with recording; or
• Sinusoidal vertical axis rotational testing; or
• Saccades testing.

Procedure Codes

Vestibular evoked myogenic potential (VEMP) tests are considered experimental/investigational and therefore non-covered as their effectiveness cannot be established based on the review of published peer reviewed literature.

Procedure Codes

Diagnosis Codes