Other estimates suggest the total number of adults who suffer from sleep apnea is much higher with a total number of 54 million cases. vagus nerve) neurostimulator electrode array and pulse generator. Epileptic Disord. PubMed PMID: 29963302; PubMed Central PMCID: PMC6009082. DISE is currently reported using either CPT codes 31575 (Laryngoscopy, flexible; diagnostic), 31622 (Bronchoscopy, rigid or flexible), or 92502 (Otolaryngologic exam under general anesthesia). WebBackground: Vagus nerve stimulation (VNS) is an established surgical treatment for medically intractable epilepsy with more than 75 000 devices implanted worldwide. 131 0 obj <> endobj For the past 20 years, teams of otolaryngologists have provided continuous cleft care for patients in Kijabe, Kenya, through Samaritans Purse World Medical Mission and partnering with IAC-CURE Childrens Hospital and Smile Train. Tzadok M, Harush A, Nissenkorn A, Zauberman Y, Feldman Z, Ben-Zeev B. The AspireSRdeviceoperates as a closed-loop system, delivering an automatic stimulation in response to an ictal heart rate increase that serves as a predictor for an imminentseizure. (62% in the new insertion group; while 59% in the replacement group had an additional benefit over their former VNS model, p=0.981). LCDs cannot contradict NCDs, but exist to clarify an NCD or address common coverage issues. This is National Coverage Determination 160.18, Vagus Nerve Stimulation. Of the 62 patients who had an existing VNS, 53% (n=33) reported 50% reduction in seizure burden when the original VNS was inserted. For optimal heart rate detection, the AspireSR had to be placed significantly more medial in the dcollet area than the Demipulse. 2. What are the population distributions of the maximum months of remission, both consecutive and overall, separately? Putting in or on biological or synthetic El Tahry R, Hirsch M, Van Rijckevorsel K, Santos SF, de Tourtchaninoff M, Rooijakkers H, Coenen V, Schulze-Bonhage A. WebCPT Code: 64590 ICD-10-CM Codes: T85.111A, G40.209 Rationales: CPT: A vagal nerve stimulator stimulator (VNS) used for the treatment of epilepsy is considered a peripheral *Only available in models 106 Put Your Oxygen Mask on before Helping Others: The Importance of Wellness. Peak TWA level in all 28 patients improved (group mean, 43%, from 724.3 to 412.3V; p<0.0001). The Spotlight on Humanitarian Efforts recognizes AAO-HNS members who are contributing their time and expertise to otolaryngologic patient needs around the globe. You could also report Z45.49 (Encounter for adjustment and management of other implanted nervous system device) as a secondary diagnosis code but it would not For the most part, codes are no longer included in the LCD (policy). (TN 1388) (TN 1388) (CR 8691), 08/2015 - This change request (CR) is the 3rd maintenance update of ICD-10 conversions/updates specific to national coverage determinations (NCDs). The AAO-HNS estimates that DISE is performed under 10% of the time any of these three codes are reported. Schneider UC, Bohlmann K, Vajkoczy P, Straub HB. The YPS kicked off an exciting new year of activities with an engaged and well-attended General Assembly at the AAO-HNSF 2020 Virtual Annual Meeting & OTO Experience, hosted by David S. Cohen, MD, our Immediate Past Chair. Sign up to get the latest information about your choice of CMS topics in your inbox. The study is sponsored by an organization or individual capable of completing it successfully. 0000006005 00000 n Remission is defined as being below the threshold on a guideline recommended depression scale assessment tool. This page displays your requested National Coverage Determination (NCD). This involves the implantation of a generator With its increased utilisation, anaesthesiologists will more frequently encounter patients with an indwelling vagal nerve stimulator (VNS), both in the elective and in the emergency surgical settings. That issuance, which includes an effective date and implementation date, is the NCD. Ravan M, Sabesan S, DCruz O. %%EOF Electrical signals are sent from the battery-powered generator to the vagus nerve via the lead. As clinical or administrative codes change or system or policy requirements dictate, CR instructions are updated to ensure the systems are applying the most appropriate claims processing instructions applicable to the policy. Early experiences with tachycardia-triggered vagus nerve stimulation using the AspireSR stimulator. Code History Fisher RS, Afra P, Macken M, Minecan DN, Bagi A, Benbadis SR, Helmers SL, Sinha SR, Slater J, Treiman D, Begnaud J, Raman P, Najimipour B. Gently pat the incisions dry with a towel after showering. Some are the result of revisions required to other NCD-related CRs released separately. Nonetheless they can be troubling in many ways to patients who then seek treatment, which often results in thyroid surgery. While there is currently only one FDA-approved HGN device, new devices are also reportable under the new codes as long as they fit under the code descriptors. Spotlight: Humanitarian Efforts Tamer A. Ghanem, MD, PhD. Applicable To Presence of brain The Vivistim Paired VNS System is a PMA-approved (P210007), FDA Breakthrough Device Epilepsy Res. endstream endobj 132 0 obj <. 2015;56(10):1639-1647. Five patients (10.9%) experienced complete seizure-freedom following implantation (4/5 in the new insertion group). AMA and CPT have registered trademarks of the American Medical Association. CPT codes are divided into three categories. Pediatric OSA has an estimated prevalence of 1%-4% in the United States.1 In most cases adenotonsillectomy (T&A) is the first-line therapy. Furthermore, application of an unsupervised fuzzy-c-mean classifier to evaluate the ability of the combined EEG-ECG based features to classify pre and post-treatment seizures achieved a classification accuracy of 85.85%. If you need more information on coverage, contact the Medicare Administrative Contractor (MAC) who published the document. Ther Adv Chronic Dis. 2018 Mar;46(3):247-262. doi: 10.11477/mf.1436203711. Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service. Neuromodulation. Medicare coverage is limited to items and services that are considered "reasonable and necessary" for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category). Accepted addition of codes 645X1, 645X2, 645X3 to identify hypoglossal versus vagal nerve stimulator services; Revision of codes 64568, 64575, 64580, 64581 to separately identify hypoglossal nerve stimulator service from vagus nerve stimulator services; and Deletion of Category III codes 0466T, 0467T, 0468T. We bear witness to human suffering. No policy-related changes are included with the ICD-10 quarterly updates. WebCPT is a registered trademark of the American Medical Association References CMS National Coverage Determinations (NCDs) NCD 160.24 Deep Brain Stimulation for Essential Tremor and Parkinsons Disease Reference NCDs: NCD 160.18 Vagus Nerve Stimulation; NCD 160.7 Electrical Nerve Stimulators CMS Benefit Policy Manual The E-37 protocol (NCT01846741) was a prospective, unblinded, U.S. multisite study of the AspireSR() in subjects with drug-resistant partial onset seizures and history of ictal tachycardia. Due to the public health emergency, the October CPT meeting was held virtually. WebThe Vagal Nerve Stimulator, for the epilepsy indication, is covered under National Coverage Determination (NCD) 160.18 and is currently billed with CPT code 64568 to report the initial implantation of the VNS device. Utilizing the new code will assist sleep surgeons in obtaining appropriate reimbursement for the work performed in the procedure. The total cohort responder rate (patients with a 50% reduction in seizure frequency compared to the pre-implantation period) was 60.9%. Some are the result of revisions required to other NCD-related CRs released separately. (TN 1658) (CR9540), 08/2016 - This change request (CR) is the 9th maintenance update of ICD-10 conversions and other coding updates specific to national coverage determinations (NCDs). _ { EJ 8Y B.;F">|{CWNM[*c:7m,\TMg-cS81u~m.Ovt^:,CpI.=j{'[9'WL0UWkph)+[~,}rbq-{S#VA6Abm0=34gE|=m0M/L!+={K%tA]@5X}Jd` 3 0 obj Previous NCD coding changes appear in ICD-10 quarterly updates that can be found at: https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/ICD10.html, along with other CRs implementing new policy NCDs. 7500 Security Blvd., Mail Stop S3-02-01 0000000856 00000 n The Food and Drug Administration (FDA) approved VNS for treatment of refractory epilepsy in 1997 and for resistant depression in 2005. Copyright 2023 Medical Billers and Coders All Rights Reserved. In order for CMS to change billing and claims processing systems to accommodate the coverage conditions within the NCD, we instruct contractors and system maintainers to modify the claims processing systems at the national or local level through CR Transmittals. Effective for services performed on or after July 1, 1999, VNS is not reasonable and necessary for all other types of seizure disorders which are medically refractory and for whom surgery is not recommended or for whom surgery has failed. 7500 Security Boulevard, Baltimore, MD 21244. If patients with bipolar disorder are included, the condition must be carefully characterized. Any policy-related changes to NCDs continue to be implemented via the current, long-standing NCD process. 0000015138 00000 n Please enable "JavaScript" and revisit this page or proceed with browsing CMS.gov with 2016 Jun 1;18(2):155-62. doi: 10.1684/epd.2016.0831. If you would like to extend your session, you may select the Continue Button. endobj Acceptance of advertising in the Bulletin in no way constitutes approval or endorsement by AAO-HNS of products or services advertised unless indicated as such. Previous NCD coding changes appear in ICD-10 quarterly updates that can be found at: https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/ICD10.html, along with other CRs implementing new policy NCDs. The results suggest that the AspireSR device provides an early and meaningful benefit to drug-resistant epilepsy patients, which is relevant for both patients with new insertions and those with replacements of former VNS devices6). To view all forums, post or create a new thread, you must be an AAPC Member. What is the time from treatment until remission scores are first achieved? It describes most of the procedures performed by healthcare providers across various sites of service. WebIn the FFS system, the facility is eligible to be reimbursed a maximum fee of $16,200 for the complete device or $8,100 for a partial replacement of the device, in addition to the (TN 1122) (TN 1122) (CR 7818), 05/2014 - CMS translated the information for this policy from ICD-9-CM/PCS to ICD-10-CM/PCS according to HIPAA standard medical data code set requirements and updated any necessary and related coding infrastructure. PubMed PMID: 29702409. WebCPT code 61885 groups to APG 223 (Level III Nerve Procedures) with an APG downstate payment including capital will be $15,390. Electrical signals are sent from the battery-powered generator to the vagus nerve via the lead. 87 0 obj <> endobj xref 87 28 0000000016 00000 n 67.4% experienced shorter seizure duration post-implantation. 171 0 obj <>stream Section Spotlight: Women in Otolaryngology (WIO). The patient is experiencing a major depressive episode (MDE) as measured by a guideline recommended depression scale assessment tool on two visits, within a 45-day span prior to implantation of the VNS device. For CPT, Category refers to the division of the code set. This email will be sent from you to the An NCD becomes effective as of the date of the decision memorandum. Final results must be reported in a publicly accessibly manner; either in a peer-reviewed scientific journal (in print or on-line), in an on-line publicly accessible registry dedicated to the dissemination of clinical trial information such as ClinicalTrials.gov, or in journals willing to publish in abbreviated format (e.g., for studies with negative or incomplete results). "JavaScript" disabled. [(3)New Therapeutic Modalities using Seizure Detection Devices for Medically Refractory Epilepsy:AspireSR and the RNS System]. The details of the prospective longitudinal study must be described in the original protocol for the double-blind, randomized, placebo-controlled trial. Medicare Administrative Contractors (MACs) are required to follow NCDs. Vagal nerve stimulation is a neurosurgical treatment modality approved for the management of drug-resistant epilepsy. Several years ago the Council of State Governments (CSG) was asked to develop a model compact for allied health professionals, in this case, audiologists and speech-language pathologists. Epilepsy Behav. These NCD coding changes are the result of newly available codes, coding revisions to NCDs released separately, or coding feedback received. The mean follow-up was 137.5 months (range 2-29 months). CPT codes are divided into three categories. At preimplantation baseline, TWA was elevated above the 47-V abnormality cutpoint in 23 (82%) patients with drug-resistant epilepsy. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. In addition, CMS will review studies to determine if they meet the 13 criteria listed below. Review the article, in particular the Coding Information section. Separate discussions in the protocol may be necessary for populations eligible for Medicare due to age, disability or Medicaid eligibility. 0000004849 00000 n trailer <<9D37B4BC7D4D481FAAF012B1E1A26D7E>]/Prev 42768/XRefStm 1093>> startxref 0 %%EOF 114 0 obj <>stream Results of application of this methodology to compare 105 pre-VNS treatment and 107 post-VNS treatment seizures revealed that seizures that were acutely stimulated using VNS had a reduced ictal spread as well as reduced impact on cardiovascular function compared to the ones that occurred prior to any treatment. 4) Visit Medicare.gov or call 1-800-Medicare. An NCD sets forth the extent to which Medicare will cover specific services, procedures, or technologies on a national basis. implant encounter) and device analysis and programming services. The principal purpose of the study is to test whether the item or service meaningfully improves health outcomes of affected beneficiaries who are represented by the enrolled subjects. CMS guidance on payment is listed below. Japanese. 2023 LivaNova PLC. The study design is methodologically appropriate and the anticipated number of enrolled subjects is sufficient to answer the research question(s) being asked in the National Coverage Determination. Was your Medicare claim denied? As the new CPT codes cover the procedure in its entirety and are specific to HGN, the Category III add-on codes (0466T, 0467T, 0468T) used to report these codes will be deleted from the code set in 2022. No policy-related changes are included with these updates. % Additionally, the AMA does not create CPT codes for specific devices. If an NCD does not specifically exclude/limit an indication or circumstance, or if the item or service is not mentioned at all in an NCD or in a Medicare manual, an item or service may be covered at the discretion of the MAC based on a Local Coverage Determination (LCD). A quantitative feature was obtained from EEG data around ictal events collected during a 3-5day epilepsy monitoring unit (EMU) visit prior to VNS implantation and following one month after VNS implant. In our 14 operations, we had no significant short-term complications. In 16 (70%) patients, TWA level was reduced during VNS treatment to <47V, thereby converting positive TWA test results to negative. 0000013799 00000 n DISE has been performed by otolaryngologists for almost 30 years. Some are the result of revisions required to other NCD-related CRs released separately that included ICD-10 coding. Edits to ICD-10 and other coding updates specific to NCDs will be included in subsequent quarterly releases and individual CRs as appropriate. H\n0y Implementation date: 01/04/2016 Effective date: 10/1/2015. AVNSTherapy generator model, AspireSR, was introduced and approved forCE Markingin February2014. You can use your browser's Print function (Ctrl-P on a PC or Command-P on a Mac) to view a print preview and then select PDF as the output. WebAt 1 year following replacement with responsive VNS Therapy device in patients who were not already seizure-free with conventional VNS Therapy (n=17) Responsive VNS Therapy devices include Normal Mode, Magnet Mode and AutoStim Mode. The contractor information can be found at the top of the document in the Contractor Information section (expand the section to see the details). 0000003663 00000 n Whether the highly interesting CBSD feature will provide an additional benefit for the patients, and will rectify the additional costs, respectively, cannot be answered in the short-term. The vagal nerve stimulator AspireSR 106 is also a responsive device which, in addition to basal stimulation, is activated by tachycardia. All other information remains the same. These new codes will become part of the CPT code set in 2022. The only hypoglossal nerve stimulator with current U.S. Food and Drug Administration (FDA) approval includes a sensor that is implanted into the chest wall intercostal muscles through a separate incision, with a subcutaneous attachment to the pulse generator to pace tongue extrusion with inspiration. All rights reserved. 0000001407 00000 n All other information remains the same. (TN 1580 ) (CR9252), 04/2016 - Transmittal 1630, dated February 26, 2016, is being rescinded and replaced by Transmittal 1658 to (1) remove duplicate spreadsheet NCD210.3, (2) add missing spreadsheet NCD20.33, (3) add B/MAC to requirement 3 at request of WPS/B, (4) rename the spreadsheet titles, and, (5) provide a link to the attached spreadsheets for more efficient ease of reference and accessibility. The 2023 edition of ICD-10-CM Z96.82 became effective on October 1, 2022. (You may have to accept the AMA License Agreement.) Effective for services performed on or after July 1, 1999, VNS is reasonable and necessary for patients with medically refractory partial onset seizures for whom surgery is not recommended or for whom surgery has failed. The NCD will be published in the Medicare National Coverage Determinations Manual. Deep brain stimulation of the anterior nucleus of the thalamus is used in Europe for intractable epilepsy and yields similar response rates to RNS using duty cycle stimulation 5). VNS with AutoStim achieves maintenance of prior-established seizure control with markedly less energy consumption and can also improve seizure control as compared to the former stimulator model4). (TN 11400) (CR12705), 06/2022 - Transmittal 11400, dated May 4, 2022, is being rescinded and replaced by Transmittal 11460, dated, June 17, 2022, to update NCD 90.2, NGS, spreadsheet to conform with changes in CR 12124, and change the implementation date for all business requirements except 12705.6 to 30 days from issuance of this correction. 0000008660 00000 n Epub 2015 Dec 13. Enter the CPT/HCPCS code in the MCD Search and select your state from the drop down. Epub 2016 Jul 21. 2 0 obj No policy-related changes are included with these updates. Schneider et al. Category I is the most common and widely used set of codes within CPT. The results must include number started/completed, summary results for primary and secondary outcome measures, statistical analyses, and adverse events. The results must be made public within 12 months of the studys primary completion date, which is the date the final subject had final data collection for the primary endpoint, even if the trial does not achieve its primary aim. These new codes will become part of the CPT code set in 2022. They are outstanding models to emulate in fostering a global otolaryngology community. These NCD coding changes are the result of newly available codes, coding revisions to NCDs released separately, or coding feedback received. Baseline elevation and reduction in cardiac electrical instability assessed by quantitative T-wave alternans in patients with drug-resistant epilepsy treated with vagus nerve stimulation in the AspireSR E-36 trial. endstream endobj startxref What are the patient variables associated with successful treatment of TRD with VNS? Your AAO-HNS Community of Support: You Will Never Walk Alone. SenTivais an implantable and programmable pulse generator for treatment of refractory epilepsy. The patients depressive illness meets a minimum criterion of four prior failed treatments of adequate dose and duration as measured by a tool designed for this purpose. 2020;111:107280. The current device, produced by Inspire Medical Systems, has been implanted thousands of times since its FDA approval in May 2014. An implantable vagus nerve stimulator has been approved by the Food and Drug Administration (FDA) to treat epilepsy and depression. 2023 ICD-10-PCS Procedure Code 00HV4MZ Insertion of Neurostimulator Lead into Spinal Cord, Percutaneous Endoscopic Approach 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code ICD-10-PCS 00HV4MZ is a specific/billable code that can be used to indicate a procedure. (TN 11391) (CR12606), 05/2022 - This Change Request (CR) constitutes a maintenance update of ICD-10 conversions and other coding updates specific to NCDs. Applicable CPT code for VNS is CPT code 64568: Incision for implantation of cranial nerve (e.g. In order to confirm the patient has MDD, accepted diagnostic criteria from the most current edition of the Diagnostic and Statistical Manual for Mental Disorder (DSM) and a structured clinical assessment are to be used. |_W+ This NCD has been or is currently being reviewed under the National Coverage What is the time from treatment until response scores are first achieved? Determination process. Medicare Coverage for Vagus Nerve Stimulation (VNS), VNS treatment is reasonable and necessary for patients with medically refractory partial-onset seizures for whom surgery is not recommended or for whom surgery has failed. The intraoperative handling was comparable and did not lead to a significant increase in operation time. CSG is an organization committed to working with state officials to shape public policy and includes a program dedicated to developing interstate compacts. National Coverage Determinations (NCDs) are national policy granting, limiting or excluding Medicare coverage for a specific medical item or service. Some are the result of revisions required to other NCD-related CRs released separately that included ICD-10 coding. The purpose of this proposed change, which is supported by the AAO-HNS, is to clarify that the code is an add-on code that cannot be separately reported for Medicare patients. The closer the stimulation to seizure onset, the shorter the seizure duration2, Helps prevent seizures by delivering treatment at regular intervals all day, every day1, Helps stop or shorten a seizure by responding to a rapid increase in heart rate, a potential seizure biomarker1,3,4, *Only available in models 106, 1000, and 1000-D, Helps stop or shorten a seizure once it starts by passing the included VNS Therapy Magnet over the generator1, At 1 year following replacement with responsive VNS Therapy device in patients who were not already seizure-free with conventional VNS Therapy (n=17). The TWA level was assessed interictally by the Modified Moving Average (MMA) method. 2018 Jul;9(7):135-142. doi: 10.1177/2040622318774173. What is the rate of remission (defined as person months of response/total months of study participation)? If appropriate, the Agency must also change billing and claims processing systems and issue related instructions to allow for payment. For this supplementary claims processing information we rely on other CMS publications, namely Change Requests (CR) Transmittals and inclusions in the Medicare Fee-For-Service Claims Processing Manual (CPM). No Shinkei Geka. The patient must be in a major depressive disorder (MDD) episode for two years or have had at least four episodes of MDD, including the current episode. vagus nerve) neurostimulator electrode array and pulse generator. Epub 2017 Apr 11. If a study is regulated by the Food and Drug Administration (FDA), it is also in compliance with 21 CFR Parts 50 and 56. x]YH~74p9h4v{kkRtIJ-oFK.K"2"2~]e^?\nXm?;z}6enCo? Of this patient population, approximately 13% of men and 6% of women have moderate to severe obstructive sleep apnea (apnea-hypopnea index or AHI 15.). The principal investigator must submit the complete study protocol, identify the relevant CMS research questions that will be addressed and cite the location of the detailed analysis plan for those questions in the protocol, plus provide a statement addressing how the study satisfies each of the standards of scientific integrity (a. through m. listed above), as well as the investigators contact information, to the address below. PubMed PMID: 29567875. Any policy-related changes to NCDs continue to be implemented via the current, longstanding NCD process. generator, any type. NCDs are made through an evidence-based process, with opportunities for public participation. All rights reserved. endstream endobj startxref It is important to note that the Centers for Medicare & Medicaid Services has a technical correction in the calendar year 2021 Medicare Physician Fee Schedule proposed rule changing the global status of CPT code 0466T to ZZZ. NCDs do not contain claims processing information like diagnosis or procedure codes nor do they give instructions to the provider on how to bill Medicare for the service or item. (TN 70) (CR 5612), 09/2012 - CMS translated the information for this policy from ICD-9-CM/PCS to ICD-10-CM/PCS according to HIPAA standard medical data code set requirements and updated any necessary and related coding infrastructure. However, much advocacy work remains to be done. 0000012536 00000 n 982 0 obj <> endobj (TN 1708) (CR9751), 11/2016 - This change request (CR) is the 9th maintenance update of ICD-10 conversions and other coding updates specific to national coverage determinations (NCDs). 5. Effective date 07/01/1999. The research study protocol specifies the method and timing of public release of all prespecified outcomes to be measured including release of outcomes if outcomes are negative or study is terminated early. Responsive VNS Therapy devices include Normal Mode, Magnet Mode and AutoStim Mode. recommended the consideration of the AspireSR in patients with documented ictal tachycardia to provide a substantial number of patients for later seizure outcome analysis13). 2015 Apr;157(4):721-8. doi: 10.1007/s00701-015-2362-3. MACs can be found in the MAC Contacts Report. WebCPT codes not covered for indications listed in the CPB: Transcutaneous vagal nerve stimulation - no specific code : Other CPT codes related to the CPB: 61534: Craniotomy What are the population distributions of the maximum months of response, both consecutive and overall, separately? The document is broken into multiple sections. <> Epilepsy etiology, age, age at implantation and type of seizures pre-implantation showed no correlation to response-rate. If that doesnt work please contact, Technical issues include things such as a link is broken, a report fails to run, a page is not displaying correctly, a search is taking an unexpectedly long time to complete. Another vagus nerve stimulation device is FDAapproved to be used with rehabilitation when recovering from a The size of this reduction was at least as large as that resulting from the insertion of their existing VNS in 98% (61/62) of patients. Kulju T, Haapasalo J, Rainesalo S, Lehtimki K, Peltola J. Autostimulation in Vagus Nerve Stimulator Treatment: Modulating Neuromodulation. (TN 1875) (CR10184), 05/2020 - Effective for claims with dates of service on or after February 15, 2019, the Centers for Medicare & Medicaid Services covers Food and Drug Administration-approved vagus nerve stimulator devices for treatment-resistant depression through Coverage with Evidence Development when all reasonable and necessary criteria are met. These signals are in turn sent to the brain. 0000002807 00000 n However, these disturbances, while uncomfortable in the present, can lead to new consequences and a new state. The study is not designed to exclusively test toxicity or disease pathophysiology in healthy individuals. 0000005220 00000 n Epilepsy Behav. 0000023691 00000 n The price of the device is higher than for all other models. 200.2 - ICD-9 Diagnosis Codes for Vagus Nerve Stimulation (Covered since DOS on and after July 1, 1999) WebVagus nerve stimulation (VNS) sends regular, mild pulses of electrical energy to the brain via the vagus nerve, through a device that is similar to a pacemaker. Director, Coverage and Analysis Group If you are having an issue like this please contact, You are leaving the CMS MCD and are being redirected to the CMS MCD Archive that contains outdated (No Longer In Effect) Local Coverage Determinations and Articles, You are leaving the CMS MCD and are being redirected to, NCD - Vagus Nerve Stimulation (VNS) (160.18).