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Magnetoencephalograpy

Section: Diagnostic Medical
Effective Date: August 31, 2019
Revised Date: August 01, 2019

Description

Magnetoencephalography/magnetic source imaging is a non-invasive functional imaging technique in which the weak magnetic forces associated with the electrical activity of the brain are monitored.

Criteria

Magnetoencephalography (MEG) or Magnetic Source Imaging (MSI) may be considered medically necessary for EITHER of the following indications:

  • For the purpose of determining the laterality of language function, as a substitute for the Wada test, in individuals being prepared for surgery for epilepsy, brain tumors, and other indications requiring brain resection; or
  • As part of the preoperative evaluation of individuals with intractable epilepsy (seizures refractory to at least 2 first-line anticonvulsants when standard techniques, such as MRI and EEG, that do not provide satisfactory localization of epileptic lesion(s).

MEG/MSI for all other indications is considered experimental/investigational and, therefore non-covered. Lack of scientific evidence does not support this treatment for all other indications.

 

ProcedureCodes

95965 95966 95967 S8035

Diagnosis Codes

C71.0 C71.1 C71.2 C71.3 C71.4 C71.5 C71.6
C71.7 C71.8 C71.9 C79.31 D33.0 D33.1 D33.2
D43.0 D43.1 D43.2 D49.6 G40.011 G40.019 G40.111
G40.119 G40.211 G40.219 G40.311 G40.319 G40.411 G40.419
G40.803 G40.804 G40.813 G40.814 G40.823 G40.824 G40.911
G40.919 G40.A11 G40.A19 G40.B11 G40.B19 I67.1 Q28.0
Q28.1 Q28.2 Q28.3 Q28.8 Q28.9

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