Diagnosys 95930 User manual

DOC# 14126 / REV A / CN# 687 / 7-25-14
Diagnosys Quick Reference Guide:
Industry leading functional diagnostics for the private practice
Visual Evoked Potential (VEP):
CPT: 95930
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

DOC# 14126 / REV A / CN# 687 / 7-25-14 /
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Images of patient setup:
Front (Fz) Top (Cz) Back (Oz)
Amplifier setup diagram:
Sensor placement in amplifier from top to bottom:
Front (Fz, 1-), Top (Cz, Gnd), Back (Oz, 1+)
Testing procedure:
Step 1: Plug the patient into the amplifier. Use the Imped. button to ensure connection quality.
-Good Connection: the numbers on the screen will be between 0 and 5 and colored green. On
the amplifier itself, the plug for that electrode input will be bright red and steadily lit. These
inputs have been well placed.
-Borderline connection: the numbers on the screen are yellow and the numbers will be between
5 and 10. On the amplifier itself, the plug for that electrode input will be blinking slowly. These
inputs may require replacement.
-Poor Connection: the numbers on the screen will be above 10 and colored red. On the amplifier
itself, the plug for that electrode input will blink rapidly. These connections will need to re-
prepared and re-placed. Remove the electrode, scrub the skin below a second time with the skin
preparation solution, wipe away the solution, and re-place the electrode.

DOC# 14126 / REV A / CN# 687 / 7-25-14 /
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Step 2: Place the patient a distance of 57 cm in front of the screen. A measuring tape has been
provided. Ensure the patient is comfortable and occlude the left eye.
Step 3: Explain the test procedure to the patient.
"We are going to test each eye's response to an alternating checkerboard pattern of black and
white. Each eye will be tested at two different check sizes. Each of the four sections of the test
will take approximately one minute to run. All you need to do is relax, try not to blink, and
fixate on the red box in the center. That box will count down and become grey for each one
minute test."
Press the Run button at lower left. The software will remind you to test the right eye; confirm to
start the test. The test will run for approximately one minute and then stop automatically when
the result collection is complete. Press to move forward.
Step 4: Press the Run button to start step 2. The test will run for approximately one minute and
then stop automatically when result collection is complete. At this point, move the
patch/occluder to cover the right eye and press Step Forward to continue.
Step 5: Press the Run button to start step 3. The software will remind you to test the left eye;
press Ok to confirm. The test will run for approximately one minute and then stop automatically
when result collection is complete. Press Step Forward to continue.
Step 6: Press the Run button to start step 4. The test will run for approximately one minute and
then stop automatically when result collection is complete. If you press Step Forward at this
point you will be informed that you have reached the end of the test.
Step 7: Press the Print button to bring up the print preview, then press Print again to print. Save
by pressing Exit and saving the test when prompted.
NOTE: IF YOU ACCIDENTALLY ELECT NOT TO SAVE, YOU WILL BE ASKED TO CONFIRM THAT YOU WISH TO DISCARD
THE TEST. IF YOU CONFIRM YOU WISH TO DISCARD THE TEST IN ERROR, CONTACT DIAGNOSYS TO RETRIEVE THE
TEST DATA