King-Devick Test 

The King-Devick (K-D) Test is a rapid, one-to-three-minute sideline screening tool that has patients read aloud a series of single-digit numbers arranged on test cards as quickly as possible without errors. It measures saccadic eye movement, visual attention, and language integration, and a slower completion time than the patient's own preinjury baseline suggests a possible concussion.

What the King-Devick Test Measures

The King-Devick Test was designed as a rapid number-naming task that indirectly assesses the integrity of the oculomotor and afferent visual pathways along with attention and language processing. Reading numbers arranged irregularly across a card requires rapid, accurate saccadic eye movements — the same eye-movement control systems that are frequently disrupted after a concussion, even when a patient's symptom checklist looks unremarkable. Because the test integrates several functional domains at once (eye movement, attention, verbal output), it is often described as a functional screen rather than a pure test of any single cognitive domain. It is not a diagnostic test for concussion on its own; it is one input among several used to flag patients who need closer evaluation.

Administration and Timing

The test consists of three cards, each presented in a fixed order, that the patient reads aloud as quickly as possible without skipping or mispronouncing numbers. A demonstration card is typically shown first so the examiner can confirm the patient understands the task. Total administration time is commonly 1–3 minutes for all three cards combined, which makes the King-Devick Test well suited to sideline and training-room settings where a rapid screen is needed and a full neuropsychological battery is not practical in the moment. Errors (skipped or misread numbers) are tracked alongside time, since some protocols also weight error count in the overall impression of the result.

Scoring and Interpretation

The primary K-D score is the total time in seconds required to complete all three cards, summed across trials. There is no single fixed population-wide "pass/fail" time cutoff for the King-Devick Test — normal reading and naming speed varies meaningfully with age, reading ability, and language proficiency. Instead, the test is designed to be interpreted against an individual's own preseason or preinjury baseline: a meaningfully slower post-injury time relative to that same patient's baseline is the primary criterion for a positive or abnormal result. In most protocols, an increase in completion time, particularly alongside a rise in errors, is treated as clinically significant and warrants further evaluation rather than automatic clearance to return to activity. Where no baseline exists, results should be interpreted cautiously and in the context of the full clinical picture rather than compared to a fixed external norm.

As with other rapid sideline tools, sensitivity is generally highest in the acute window immediately following a suspected injury and tends to decline over the following days, so a normal K-D result at 24–72 hours post-injury does not rule out concussion on its own.

Clinical Use Case

The King-Devick Test is most often used as a rapid sideline or training-room screening tool in athletics, where it can be administered in minutes by a coach, athletic trainer, or clinician without specialized equipment beyond the test cards or app. It is commonly used alongside other brief sideline tools — symptom checklists, balance testing, and brief cognitive screens — as part of a broader multi-component concussion assessment rather than as a standalone diagnostic instrument. Because the underlying oculomotor and attentional systems it probes are also relevant outside of sports (in general trauma, emergency department triage, and outpatient follow-up), some clinics extend K-D screening into these broader concussion-care settings.

Given its brevity and baseline-dependence, the King-Devick Test complements but does not replace formal neurocognitive testing when a patient's symptom trajectory or clinical picture warrants deeper evaluation — see when to refer for neuropsych testing for guidance on that decision point.

Billing Context

The King-Devick Test is a brief, non-standardized-battery clinical maneuver rather than a formal psychometric test administration, so it is typically bundled into the evaluation and management (E/M) encounter rather than billed separately under the neurocognitive testing code family (96116–96146). This is consistent with how other rapid sideline tools such as the SAC and BESS are generally handled. Actual billing treatment depends on the setting (sideline or emergency evaluation versus outpatient neuropsych clinic) and payer-specific policy, so practices should confirm current guidance with their Medicare Administrative Contractor or payer before billing separately for K-D administration. When K-D results prompt a fuller outpatient workup, that subsequent battery (for example, instruments captured under 96132 or 96136) is billed according to its own documentation and time requirements. For an overview of how this code family is structured, see 96116 and the related administration codes.

Where This Sits in the Kavera Protocol

Within Kavera's Concussion module, sideline-style screens like the King-Devick Test represent the acute, in-person moment of injury identification that precedes the between-visit monitoring period Kavera is built to support. Once a patient is identified as concussed, Kavera's assessment battery — spanning symptom scales, mood and sleep screens, and cognitive-domain tests — is delivered to the patient between visits to track recovery trajectory, generating the documentation that supports both neurocognitive testing billing and Remote Therapeutic Monitoring billing under codes such as 98978. The King-Devick result itself is not part of that between-visit battery, but the recovery trajectory it helps flag at the point of injury is exactly what Kavera's ongoing monitoring is designed to track through resolution.

How Kavera Handles This

King-Devick is a sideline and first-visit tool; Kavera records the time and error count at baseline and re-evaluation so the clinic score sits next to the between-visit data rather than on a card in a drawer. It is not delivered remotely. Self-Serve practices run this with their own staff. On Managed, Juliet Mott's team runs it and bills it under your credentials.

FAQ

Is the King-Devick Test the same as a full neuropsychological evaluation?

No. The King-Devick Test is a brief screening tool that takes a few minutes to administer and flags possible oculomotor or attentional impairment. It does not replace formal neurocognitive testing, which evaluates multiple domains in depth and typically takes much longer.

What counts as an abnormal King-Devick result?

There is no fixed population-wide time cutoff. In most protocols, a result is considered abnormal when completion time is meaningfully slower than the patient's own preinjury baseline, particularly if accompanied by more errors.

Can the King-Devick Test be used without a baseline?

It can be administered without a baseline, but interpretation is more limited since normal completion times vary by age and reading ability. Where a baseline exists, it is the preferred comparison point.

Is the King-Devick Test billable separately from the office visit?

Generally no — it is typically bundled into the E/M encounter rather than billed under the neurocognitive testing codes, since it is a brief clinical maneuver rather than a formal test battery. Confirm current treatment with your payer.

How does King-Devick fit with Kavera's platform?

Kavera does not perform the sideline King-Devick screen itself. It picks up after a concussion is identified, delivering the between-visit assessment battery that tracks recovery and supports RTM and neurocognitive testing documentation.