Anthem Blue Cross Connecticut MED.00137 Eye Movement Analysis Using Non-spatial Calibration for the Diagnosis of Concussion Form

Effective Date

06/28/2023

Last Reviewed

05/11/2023

Original Document

  Reference



Concussion, (also known as mild traumatic brain injury), occurs following direct or indirect external trauma to the head that causes a change in brain function. Because there is no single objective measure or combination of measures for diagnosis of concussion, physicians must rely on expert guidelines, available assessment tools and clinical judgment to make a diagnosis of concussion.

Researchers are exploring eye movement analysis that uses temporal (rather than spatial) calibration to aid in the diagnosis of concussion. The EyeBOX® (Oculogica, Inc. [New York, NY]), is the first baseline-free, temporal calibration eye movement analysis device to assist physicians in objectively evaluating individuals with suspected concussion.

Position Statement

Investigational and Not Medically Necessary:

Eye movement analysis using non-spatial calibration is considered investigational and not medically necessary for the diagnosis of concussion.