Effective October 1, 2013, IBC?s medical policy for intraoperative neurophysiological monitoring (INM) will be updated. Medically necessary remote (i.e., outside the operating room) and non-remote (i.e., inside the operating room) INM will be covered when the physician is monitoring one individual at a time. Previously, for remote and non-remote INM, monitoring of no more than three cases simultaneously was covered. However, the beneficial results of INM are demonstrated when a physician?s attention is focused on one individual at a time due to the potential risk for morbidity. Visit our []medical policy[] site after July 3, 2013, to review the Policy Notification for Medical Policy #07.03.14i: Intraoperative Neurophysiological Monitoring (INM). [

]About INM[

] INM refers to a variety of monitoring modalities used to ensure the integrity of neural pathways during high-risk surgeries, including vascular/cardiovascular, intracranial, endovascular, spine, orthopaedic, peripheral nerve, and otolaryngologic surgeries. INM is distinct from clinical diagnostic studies. The primary objective of INM is to identify and prevent complications in the nervous system (the spinal cord or the brain), its blood supply, or adjacent tissue, with the expectation that prompt intervention will avert permanent deficits. The American Academy of Neurology recommends that INM testing be reserved for surgical procedures in which there is a significant risk of damage to neural integrity. INM can identify new neurologic impairment, identify or separate nervous system structures (e.g., around or in a tumor), and demonstrate which tracts or nerves are still functional. INM may provide a surgeon with confirmation that no complications have been detected up to a certain point. This allows the surgeon to proceed with a more thorough surgical intervention.