Individuals with attention-deficit/hyperactivity disorder (ADHD) may have alterations in their brain wave patterns that can be measured by quantitative electroencephalography. A commercially available system, the Neuropsychiatric EEG-based ADHD Assessment Aid (NEBA®) measures the resting theta/beta ratio of the electroencephalogram. This technology is being evaluated to aid in the diagnosis of adolescents and children for whom there is a clinical suspicion of ADHD. The system is not intended to evaluate individuals for whom the clinician’s diagnosis of ADHD is negative, and the system does not generate an interpretive report in this situation. It is also proposed that the clinician’s diagnostic impression plus the results generated by the NEBA system may reduce the potential for over diagnosis of ADHD and thereby reduce the risks of administering unnecessary pharmacologic therapy in the intended-use population.
Quantitative electroencephalographic (EEG)-based assessments that report the strength, pattern and/or ratios of brain waves as a diagnostic aid for attention-deficit/hyperactivity disorder is considered investigational.
Any specific products referenced in this policy are just examples and are intended for illustrative purposes only. It is not intended to be a recommendation of one product over another, and is not intended to represent a complete listing of all products available. These examples are contained in the parenthetical e.g. statement.
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits, or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
Published peer-reviewed studies that evaluate the accuracy of commercially available devices (e.g., NEBA®) in the diagnosis of ADHD are scant. The effect/impact of this technology on health outcomes is not known.
American Academy of Neurology. (2016, November). Practice advisory: The utility of EEG theta/beta power ratio in ADHD diagnosis. Retrieved April 23, 2018 from https://www.aan.com.
BlueCross BlueShield Association. Evidence Positioning System. (11:2020). Quantitative electroencephalography as a diagnostic aid for attention-deficit/hyperactivity disorder (3.01.03). Retrieved January 8, 2021 from http://www.evidencepositioningsystem.com. (7 articles and/or guidelines reviewed)
Kim, J. W., Lee, J., Kim, H. J., Lee Y. S., & Min, K. J. (2015). Relationship between theta-phase gamma-amplitude coupling and attention-deficit/hyperactivity behavior in children. Neuroscience Letters, 590, 12-17. Abstract retrieved July 24, 2015 from PubMed database.
Kim, J., Lee, Y., Han, D., Min, K., Kim, D., & Lee, C. (2015). The utility of quantitative electroencephalography and integrated visual and auditory continuous performance test as auxiliary tools for the Attention Deficit Hyperactivity Disorder diagnosis. Clinical Neurophysiology, 126 (3), 532-40. Abstract retrieved April 20, 2017 from PubMed database.
Snyder, S. M., Rugino, T. A., Hornig, M., & Stein, M. A. (2015). Integration of an EEG biomarker with a clinician’s ADHD evaluation. Brain and Behavior, 5 (4). (Level 3 evidence)
U.S. Food and Drug Administration. (2013, July). Center for Devices and Radiological Health. De novo classification request for Neuropsychiatric EEG-Based Assessment Aid for ADHD (NEBA) System. Retrieved November 18, 2013 from http://www.accessdata.fda.gov.
ORIGINAL EFFECTIVE DATE: 4/10/2014
MOST RECENT REVIEW DATE: 3/11/2021
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.
This document has been classified as public information.