Gastric Electrical Stimulation

To ensure that a patient meets the medically necessary policy criteria, or to find out if coverage pre-determination is required, please contact the patient's payer directly.

Coding

Gastric Electrical Stimulation for Gastroparesis

Note: The hospital codes contained in this document expired 9/30/2009. Please refer to the latest Hospital Commonly Billed Codes effective October 1, 2009 through December 31, 2009.

  • ICD-9-CM Diagnosis and Procedure Codes
  • HCPCS Device Codes
  • Device C-Codes and Device Edits
  • CPT® Procedure Codes
  • MS-DRG Assignments
  • ICD-9-CM Diagnosis and Procedure Codes
  • HCPCS Device Codes
  • Device C-Codes and Device Edits
  • CPT® Procedure Codes
  • MS-DRG Assignments

Coverage

Customizable fax cover template for prior authorization of a patient who has diabetes for a neurostimulator to treat gastroparesis.

Use this form to submit a prior authorization request and start the prior authorization process.

Use this form to choose the level of service for prior authorizations.

GES idiopathic cover letter requesting prior authorization

Sample appeal letter for coverage denial of a neurostimulator to treat gastroparesis.

Customizable template for obtaining prior authorization for implantation of a neurostimulator to treat gastroparesis.

Resources

Use this template to customize your report for reimbursement after interrogating and programming the Enterra Gastric Neurostimulation System.

Humanitarian Device: The effectiveness of this device for this use has not been demonstrated.

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.