Posturography

Rotary tests evaluate the VOR. Calorics and positional tests evaluate the labyrinthine response to different types of stimulation. While the majority of patients with complaints of dizziness and imbalance are found to have vestibular dysfunction, there are a large number of these patients with normal VOR function. Posturography allows for examination of postural control under a variety of situations, and can provide information that has nothing to do with the VOR.
First, keep in mind that the term “Posturography” is not proprietary, and can describe a number of different tests. Medicare has adopted a stricter definition of what it calls “Computerized Dynamic Posturography” or CDP. The AMA has assigned a procedure code 92548 for CDP, and to qualify for this code, and be paid for the procedure, the test apparatus MUST include independent, computerized control over both the support surface, and the visual surround. Unfortunately, this equipment starts at about $60,000.
Nonetheless, posturography can be performed in a variety of ways, from the “Foam and Dome”, to a spring loaded platform measuring sway and COG, all the way up to the Equitest (Neurocom) or Balance Quest (Micromedical) that qualifies as true CDP.

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