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Common Coding Options for VNS Therapy (Vagus Nerve Stimulation)
| ICD-9-CM (DSM-IV)—DIAGNOSIS CODES |
| Depression |
| 296.2x* |
Major depressive disorder, single episode |
| 296.3x* |
Major depressive disorder, recurrent episode |
| 296.5x* |
Bipolar I disorder, most recent episode (or current) depressed |
*x = appropriate level, please specify:
0 = unspecified
2 = moderate
3 = severe, without mention of psychotic behavior
5 = in partial or unspecified remission |
| Epilepsy |
| 345.41 | Partial epilepsy with impairment of consciousness |
| 345.51 | Partial epilepsy without impairment of consciousness |
| 780.39 | Other convulsions |
| ICD-9 PROCEDURE CODES —IMPLANTATION, REPLACEMENT OR REMOVAL |
| 04.92 |
Implantation or replacement of peripheral neurostimulator lead(s) |
| 86.94 |
Insertion or replacement of single array neurostimulator pulse generator |
| 04.93 |
Removal of peripheral neurostimulator lead(s) |
| 86.05 |
Incision with removal of foreign body or device from skin and subcutaneous tissue; Removal of neurostimulator pulse generator (single array, dual array) |
| REVENUE CODES |
| 278 |
Medical device and implants |
| 360 |
General classification O.R. services |
| PHYSICIAN AND OUTPATIENT FACILITY CPT-4 CODES |
| Implant |
| 64573 |
Incision for implantation of neurostimulator electrodes; cranial nerve |
| 61885 |
Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array |
| |
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| Revision or Removal |
| 64585 |
Revision or removal of peripheral neurostimulator electrodes |
| 61888 |
Revision or removal of cranial neurostimulator pulse generator or receiver |
| ANALYSIS-PROGRAMMING—ALL SETTINGS |
| 95970 |
Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse, amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple or complex brain, spinal cord, or peripheral (ie, cranial nerve, peripheral nerve, autonomic nerve, neuromuscular) neurostimulator pulse generator/transmitter, without reprogramming |
| 95974 |
Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse, amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex cranial nerve neurostimulator pulse enerator/transmitter, with intraoperative or subsequent programming, with or without nerve interface testing, first hour |
| 95975 |
Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse, amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, each additional 30 minutes after first hour (List separately in addition to code for primary procedure) |
| DIAGNOSIS RELATED GROUPS (HOSPITAL INPATIENT ONLY) |
| 007 |
Peripheral & cranial nerve & other nerve system procedure with complications |
| 008 |
Peripheral & cranial nerve & other nerve system procedure without complications |
| MEDICARE OUTPATIENT PROSPECTIVE PAYMENT SYSTEM |
| Hospital Outpatient Category C-Codes |
| C1767 |
Generator, Neurostimulator |
| C1778 | Lead, Neurostimulator |
| Ambulatory Payment Classification (Hospital Outpatient) |
| Group | | CPT-4 Code |
| APC 0039 | Level I Implantation of Neurostimulator | 61885 |
| APC 0225 | Level I Implantation of Neurostimulator Electrodes | 64573 |
| APC 0692 | Electronic Analysis of Neurostimulator | 95974 |
| Pulse Generators | 95975 |
| APC 0218 | Level II Nerve and Muscle Tests | 95970 |
Cyberonics has compiled this coding information for your convenience. It is the provider's responsibility to file claims with appropriate ICD-9, CPT-4, HCPCS, revenue, and/or APC codes along with charges for the services provided. Please contact your local payer if you have questions regarding appropriate coding guidelines.
Cyberonics offers a VNS Therapy Reimbursement Department at
1-888-508-8082
or email VNSTherapycallcenter@cyberonics.com
Click here for prescribing and safety information. |