BlueCross BlueShield of Tennessee Medical Policy Manual

Dynamic Posturography in the Assessment of Balance

DESCRIPTION

Dynamic posturography (i.e., computerized dynamic posturography) tests balance control in situations intended to isolate the factors that affect balance in everyday experiences. Posturography (e.g. NeuroCom EquiTest®) proposes to provide quantitative information on the degree of imbalance present in an individual but does not diagnose specific types of balance disorders.

The individual wears a harness to prevent falls and stands on an enclosed platform surrounded by a visual field. By altering the angle of the platform or shifting the visual field, the test is intended to assess movement coordination and the sensory organization of visual, somatosensory, and vestibular information relevant to postural control. The individual undergoes six different testing situations designed to evaluate the vestibular, visual, and proprioceptive/somatosensory components of balance. In general terms, the test measures an individual’s balance while visual and somatosensory cues are altered.

POLICY

IMPORTANT REMINDERS

ADDITIONAL INFORMATION 

Randomized controlled studies are lacking for this technology. In addition, the existing studies fail to demonstrate clinical utility of this test that would lead to changes in management that improve outcomes. Therefore, dynamic posturography in the assessment of balance is considered investigational.

SOURCES

American Academy of Otolaryngology-Head and Neck Surgery Foundation. (2014, September). Position statement: Posturography. Retrieved March 29, 2016 from http://www.entnet.org.

BlueCross BlueShield Association. Medical Policy Reference Manual. (2:2017). Dynamic posturography (2.01.02). Retrieved January 30, 2018 from BlueWeb. (27 articles and/or guidelines reviewed)

Palmetto Government Benefits Administrators. (2018, February). Local Coverage Determination (LCD): Vestibular Function Testing (L34537). Retrieved January 30, 2018 from: https://www.cms.gov.

Olchowik, G., Tomaszewski, M., Olejarz, P., Warchol, J., & Rozanska-Boczula, M. (2014). The effect of height and BMI on computer dynamic posturography parameters in women. Acta of Bioengineering and Biomechanics, 16 (4), 53-58. Abstract retrieved March 29, 2016 from PubMed database.

U. S. Food and Drug Administration. (1995, August). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K951771. Retrieved February 2, 2010 from http://www.accessdata.fda.gov.

Vanicek, N., King, S. A., Gohil, R., Chetter, I. C., & Coughlin, P. A. (2013). Computerized dynamic posturography for postural control assessment in patients with intermittent claudication. Journal of Visualized Experiments, 2013 (82). (Level 4 evidence)

Zammit, G., Wang-Weigand, S., & Peng, X. (2008). Use of computerized dynamic posturography to assess balance in older adults after nighttime awakenings using zolpidem as a reference. Retrieved November 2, 2012 from http://www.biomedcentral.com/1471-2318/8/15. (Level 4 Evidence - Industry sponsored)

ORIGINAL EFFECTIVE DATE:  9/1992

MOST RECENT REVIEW DATE:  3/8/2018

ID_BA

Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

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