Medicare’s Approval of VEMP Testing a Positive Sign for Dizzy Patients

Every second of every day in the United States an older adult falls, making falls the number one cause of injuries and deaths from injury among older Americans, according to the Centers for Disease Control.

So when someone experiences the symptoms of dizziness and balance problems, and they seek help from a medical professional, you’d expect Medicare and health insurance to cover the diagnosis and treatment.

Unfortunately, that hasn’t been the case, until recently. Now, Medicare is covering a test commonly performed to diagnose patients experiencing dizziness and balance problems called a vestibular evoked myogenic potential test (VEMP).

VEMP testing is used to evaluate whether certain vestibular organs and associated nerves are intact and functioning normally. It also measures overall structural health of the labyrinthine (balance) organ. Responses in this test are measured from different muscles in the neck and around the eyes. VEMP testing uses adhesive, skin surface electrodes and earphones (like those used during a hearing test). Sound is played for a few seconds through the earphones, the vestibular organs are stimulated and activate muscle responses, and electrodes record the results.

VEMP is considered an essential test in accurately diagnosing a dizziness or balance disorder. Many health insurers are expected to follow suit and cover the test as well.

Associated Audiologists offers a comprehensive dizziness and imbalance clinic for our patients. This clinic uses state-of-the-art technology to evaluate individuals suffering from dizziness, balance problems, and/or who have a history of falls related to inner-ear disorders. The program is staffed by Danielle Dorner, Au.D., Vestibular Audiologist, who sees patients at our Overland Park, and Northland clinics.

Other testing available includes:

  • Audiologic Testing: Evaluates the hearing portion of a patient’s ear. This allows us to define cause, type and degree of hearing loss. This testing is important for dizzy and off-balance patients because small unnoticed hearing changes can indicate inner ear damage or other medical problems.
  • Auditory Brainstem Response (ABR): This test helps us evaluate the neural integrity of the nerve going to the hearing part of the inner ear. This test is often used to further explain why a person might have unilateral symptoms or test findings. This test helps us evaluate the nerve quality and function of the inner ear hearing nerve.
  • Video Head Impulse Test (vHIT): Evaluates the patient’s vestibulo-ocular reflex (VOR), both branches of the vestibular nerve, each of the six semicircular canals individually, and central vestibular compensation.
  • Dynamic Visual Acuity Test: This test is fairly similar to the VAT, but the test protocol is slightly modified. It may be easier for some patients to perform.
  • Electrocochleography (ECOG): This technique records electricity generated in the inner ear and auditory nerve. The test helps rule out an abnormal accumulation of fluid within the inner ear that may be causing acute attacks of true room-spinning vertigo.
  • Electro-oculography: This testing evaluates very specific eye movements that are coordinated by the equilibrium centers of the brain. Damage to these brain areas can cause dizziness.
  • Otoacoustic emission (OAE) testing: This test helps us evaluate the function of the inner ear. This test also helps us further differentiate where an individual’s hearing loss is coming from. This is important for patients who have equilibrium disorders, as it further defines the location of an inner ear problem.
  • Rotary Chair: This advanced test utilizes a computer-controlled motorized chair to stimulate the ear at different speeds. A patient’s eye movements are also recorded with video goggles. This test allows us to assess the overall health of the inner ears and how the brain is adapting to a vestibular disorder.
  • Sensory Organization Test: This test helps us identify balance problems. With careful evaluation, it allows your audiologist to determine the cause of your imbalance and identify a potential fall risk.
  • Tympanometry/immittance testing: Helps us rule out fluid in the middle part of the ear, which can impact other vestibular test results. This test also allows us to evaluate nerve responses.
  • Video/Electro-nystagmography (VNG/ENG): This test is composed of a number of subtests. For this testing, a patient wears video goggles or electrodes. These allow us to watch for small eye movement abnormalities, which can indicate an inner ear problem. There are also sub-tests that can help us identify positional vertigo and/or permanent ear damage. This testing also looks at the top portion of the nerve going to the equilibrium part of the inner ear.

Schedule an appointment with our dizziness and balance expert, Dr. Dorner. Or, for more information about dizziness and balance disorders, download our free e-book, What to Know about Dizziness and Imbalance.