Blue Cross of Idaho Logo

Express Sign-on

Thank you for registering with Blue Cross of Idaho

If you are an Individual or Family Member under age 65, please register here.

If you are an Medicare or Medicare Supplement member, please register here.

New Options for Affordable Health Insurance

MP 2.01.10 Topographic Brain Mapping

Medical Policy
Section
Medicine
Original Policy Date
12/1/95
Last Review Status/Date
Reviewed by consensus/3:2003
Issue
3:2003
Return to Medical Policy Index

Description

Topographic brain mapping (TBM) is an extension of conventional electroencephalography. TBM, sometimes referred to as brain electrical activity mapping (BEAM), involves the computerized analysis and topographic display of EEG rhythms and evoked potential data on a color video screen. A wide assortment of maps can be created to represent different measurement patterns. The purpose of TBM is to identify patterns that distinguish pathological groups from normal ones.


Policy

Topographic brain mapping is considered investigational.


Policy Guidelines

No applicable information


Benefit Application

BlueCard/National Account Issues

Denial of this procedure is applicable for contracts or certificates of coverage that maintain an exclusion for investigational services.


Rationale

A search of the literature was completed through the MEDLINE database for the period of January 1992 through February 20, 1997. The search strategy focused on references containing the following Medical Subject Heading:

– Brain Mapping

Research was limited to English-language journals on humans.

See also:

– TEC Evaluation & Coverage 1987: p. 174

 

Codes

Number

Description

CPT  No Code 
ICD-9 Procedure  No Code 
ICD-9 Diagnosis    Investigational for all codes 
HCPCS  S8040  Topographic brain mapping 
Type of Service  Medical/Diagnostic 
Place of Service  Inpatient 


Index

Topographic brain mapping


Policy History

Date Action Reason
12/1/95 Add to Medicine section New policy
7/31/97 Replace policy Reviewed without changes
7/12/02 Replace policy Policy reviewed without literature review; new review date only
10/9/03 Replace policy Policy reviewed without literature review; policy no longer scheduled for further review as this topic was of minimal interest to plans. Likely that topographic brain mapping is coded for by CPT code for quantitative EEG.


Search for Policies

Policy Feedback