To ensure that a patient meets the medically necessary policy criteria, or to find out if prior authorization/pre-determination is required, please contact the patient's payer directly.
* Humanitarian Device: The effectiveness of this device for the treatment of dystonia or obsessive-compulsive disorder has not been demonstrated.
OCD articles to help support DBS for OCD or to use for reference.
Template to write letter on behalf of patients when requesting OCD prior authorization or appealing a denial.
Use this form to choose the level of service for prior authorizations.
A sample appeal letter for investigational/experimental, not medically necessary and is not a standard of care responses.
Sample cover letter template for obtaining prior authorization.
Customizable template for obtaining prior authorization for implantation of a neurostimulator to treat Essential Tremor.
Customizable template for obtaining prior authorization for implantation of a neurostimulator to treat Parkinson's Disease.
Medtronic has compiled this information for your convenience. It is always the provider's responsibility to determine coverage and submit appropriate codes, modifiers, and charges for the services that were rendered. Contact your local carrier/payer for interpretation of appropriate coverage and coding policies.
For unapproved uses, consult with your local carrier/payer before seeking reimbursement for use of a product that may be inconsistent with or not expressly specified in the FDA cleared or approved labeling (manual). Some payers may have policies that make it inappropriate to submit claims for such items or related services.