The Neuropsychological examination is one of the methods of diagnosing neurodevelopmental, neurogenerative and acquired disorders of brain function. It is frequently a part of the overall neurodiagnostic assessment which includes other neurometric techniques such as CT, MRI, EEG, SPECT. The purpose of the neuropsychological examination is to assess the clinical relationship between the brain/central nervous system and behavioral dysfunction. It is a neurodiagnostic, consultative service and NOT a mental health/psychological evaluation or psychiatric treatment service.
The Social Security Administration defines neuropsychological testing as the “administration of standardized tests that are reliable and valid with respect to assessing impairment in brain functioning.” The examination is performed by a qualified neuropsychologist who has undergone specialized education and intensive training in the clinical and neuroanatomy, neurology, and neurophysiology. The neuropsychologist works closely with the primary or consultant physician in assessing patient cerebral status. Neuropsychological services are designated as “medicine, diagnostic” by the federal Health Care and Financing Administration (HCFA), are subsumed under “Central Nervous System Assessments” in the 1996 CPT Code Book, and have corresponding ICD diagnoses.
Neuropsychological examinations are clinically indicated and medically necessary when patients display signs and symptoms in intellectual compromise, cognitive and/or neurobehavioral dysfunction that involve, but are not restricted to, memory deficits, language disorders, impairment of organization and planning, difficulty with cognition, and perceptual abnormalities. Frequent etiologies include: head trauma, stroke, tumor, infectious disease, toxic exposure metabolic abnormalities, autoimmune disease, genetic defects, learning disabilities, and neurodegenerative disease. The examination entails the taking of and extensive history (including review of medical records) and the administration of a comprehensive battery of tests that can take many hours and requires intensive data analysis. Consultation with other medical professionals in common, such as neurologists, neurosurgeons and radiologists. The sensitivity of neuropsychological tests is such that they often reveal abnormality in the absence of positive findings on CT and MR scan.
Additional information in available upon request regarding the medical nature of neuropsychological examination and its role as part of the standard care of patients with congenital and acquired brain dysfunction.