Monitoring of the progression of cognitive impairment secondary to neurological disorders.Īetna considers neuropsychological (NPT) or psychological testing (PT) medically necessary when needed to enhance psychiatric or psychotherapeutic treatment outcomes after a detailed diagnostic evaluation if:.Differential diagnosis between psychogenic and neurogenic syndromes.Assessment of neurocognitive functions to assist in the development of rehabilitation and/or management strategies for persons with diagnosed neurological disorders.Assessment of neurocognitive abilities following traumatic brain injury, stroke, or neurosurgery or relating to a medical diagnosis, such as epilepsy, hydrocephalus or AIDS.The instruments selected have the empirically substantiated reliability, validity, standardized administration and clinically relevant normative data to assess the diagnostic question or treatment planning goals.Įxamples of medically necessary indications for NPT testing include, but are not limited to:.The testing techniques submitted are both validated for the age and population of the member and they are the most updated version of the instrument and.The testing techniques do not represent redundant measurements of the same cognitive, behavioral or emotional domain and.The testing techniques are validated for the proposed diagnostic question or treatment plan and.The number of hours or units requested for testing does not exceed the reasonable time necessary to address the clinical questions with the identified measures and.Aetna considers neuropsychological testing (NPT) medically necessary when provided to aid in the assessment of cognitive impairment due to medical or psychiatric conditions, when all of the following criteria are met: