Deep Brain Stimulation

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.

Coding

Commonly Billed Codes provide relevant billing and coding guidance. Included in the documents are procedure and device codes to be used when billing, along with Medicare National Average payment rates.

Note: Our Commonly Billed Codes state that the physician payment amounts are valid through February 28, 2010. On March 2, 2010, the president signed H.R. 4691, the Temporary Extension Act of 2010 into law. This legislation includes a provision that freezes Medicare physician payments at their current level until March 31, 2010.

Deep Brain Stimulation for Parkinson's Disease and Essential Tremor
  • ICD-9-CM Diagnosis and Procedure Codes
  • HCPCS II Device Codes
  • Device C-Codes and Device Edits
  • CPT® Procedure Codes
  • MS-DRG Assignments
  • Codes and Payment for Kinetra® and Soletra®
Deep Brain Stimulation for Dystonia*
  • ICD-9-CM Diagnosis and Procedure Codes
  • HCPCS II Device Codes
  • Device C-Codes and Device Edits
  • CPT® Procedure Codes
  • MS-DRG Assignments
Deep Brain Stimulation for Obsessive-Compulsive Disorder*
  • ICD-9-CM Diagnosis and Procedure Codes
  • HCPCS II Device and Drug Codes
  • Device C-Codes and Device Edits
  • APC Codes
  • DRG Assignments

* Humanitarian Device: The effectiveness of this device for the treatment of dystonia or obsessive-compulsive disorder has not been demonstrated.

Coverage

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.