Intraoperative Neuromonitoring

IONM consists of both a technical and professional component. The monitoring is performed by a certified or board eligible technologist participating in the operating room and is overseen remotely in real-time by a neurologist (professional component). Together, these components combine to provide patient safety and positive outcomes

What is IONM?

Surgical procedures that involve the nervous system, directly or indirectly places neural structures at risk. The integrity of these structures can be monitored during the procedure using various techniques. These techniques are known as intraoperative neurophysiologic monitoring, or IONM. Proper IONM uses a team approach, with the team consisting of a technologist in the operating room and an off-site oversight physician.

How does IONM work?

A technologist uses electrodes attached to a patient’s body during complex surgeries. These electrodes send electrical impulses through your body in order to monitor nerve pathways. The speed and intensity of the signals are constantly compared to the patient’s baseline standards. This evaluation provides the surgeon with immediate feedback and warning working to reduce potential for nerve injury. IONM has been proven to increase patient safety and improve outcomes in surgical procedures.

What is the IONM process?

Prior to surgery, electrodes ranging from sticky pads to small needles are placed on areas of the body associated with the nerve structures at risk. The patient’s baseline recordings are taken before surgery begins and are repeated throughout the procedure. If a change in signal is detected, the technologist notifies the surgeon so that appropriate actions are made to prevent a nerve injury.

Why is IONM important?

If a change in nerve activity is noted during the procedure, the technologist reports this change to the surgeon and to the oversight physician. At that point the technologist, oversight physician and surgeon work as a team to decrease the risk of permanent nerve damage.

IONM is the gold standard of patient care for spine, brain, vascular, and ENT surgeries. The number of IONM cases has grown rapidly as benefits to patients, surgeons and hospitals become proven and more widely understood.

How is IONM billed?

Typically, an Explanation of Benefits (EOB) is provided by the insurance company that details Assure’s charges, their allowances, and payments. In the cases of deductible or co-insurance, Assure will bill you directly for reimbursement.

In most instances, the patient’s medical insurance carrier will pay Assure directly. However, in some instances, the medical insurance carrier will pay the patient directly.

For more information or to contact our Billing Department, please call us Toll Free at 877-208-1373 or email

Why is my surgeon using IONM?

Your well-informed surgeon wants to utilize the most advanced technology and clinical expertise to provide real time testing of nerve functions during procedures. This support will assist him/her in reducing patient risk of temporary or permanent neural damage and help achieve the best possible outcome for your surgery.