Medicare National Coverage Determinations (NCD) Manual (Pub. 100-03), Ch. 1 § 50.8
Ultrasonic Surgery
50.8 - Ultrasonic Surgery
(Rev. 1, 10-03-03)
CIM 35-4
Reimbursement may be made for ultrasonic surgery when required in the treatment of
patients with severe and recurrent episodes of vertigo due to Meniere’s syndrome. This
procedure utilizes a machine that produces ultrasonic waves of high intensity and
frequency that selectively irradiate certain portions of the inner ear thereby destroying the
tissue. The procedure is usually done under local anesthesia, and requires the services of
a surgeon and another individual who is responsible for calibrating the electrical
equipment, and who assists in observing certain physical changes (e.g., movement of the
eyes, “nystagmus") indicative of inner ear reaction to the ultrasonic destruction. Except
in rare instances the desired result is achieved with one treatment. At present, there are
two different approaches being used to apply the ultrasound to the inner ear: one through
the lateral semicircular canal and, more recently, a simpler approach from a technical
viewpoint, through the round window.