Diagnosys 95930 Quick Reference Manual

Diagnosys Quick Reference Guide:
Industry leading functional diagnostics for the private practice

Explanation for patients:

This test is similar to an EKG, except that it tests parts of your visual system instead of your heart.
We stimulate your visual system using patterns of light and measure the electrical response in
the brain and the optic nerve. The size, shape, and speed of these responses can point to various
disorders of the visual system.
This test involves putting electrodes on the scalp and forehead (much like a sleep study) and
measuring the response as you look at an alternating checkerboard pattern of black and white.

Materials:

 Lemon Prep® or Nu Prep® exfoliating scrub
 Ten 20® conductive paste
 Three gold cup sensors
 Clear tape (three strips)
 Clean up materials (soap, water, paper towel)
 Felt tip pen
 Eye patch or occluder

Patient setup:

 Prep three gold cup sensor sites with
Lemon Prep® or Nu Prep® exfoliating
scrub
 Place gold up reference sensor (-) on
forehead with Ten 20® conductive
paste and tape
 Place gold cup ground sensor (GND) on
top of head, centered between both
sensors with Ten20 ® & taped in place
 Place gold cup active sensor (+) placed
approximately 2 cm above inion &
taped in place
Visual Evoked Potential (VEP):
CPT: 95930
DOC# 14126 / REV A / CN# 687 / 7-25-14