Get Deep Brain Stimulator Letter Of Medical Necessity

Z96. 82 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

We are using the diagnosis code of T85. 190 (Other mechanical complication of implanted electronic neurostimulator of brain electrode (lead), initial encounter) for the replacement of a deep brain stimulator generator (2 leads, 61886) because the battery died.

An ideal candidate for DBS surgery is under 80 years old, is in good health, and is not presenting with any major cognitive symptoms. Patients who fluctuate between “on” and “off” medication states are usually good surgical candidates, as are those who have troublesome dyskinesias.

DBS is FDA-approved and covered by most health insurance companies. Some insurance companies require prior authorization before having surgery, and some do not fully understand DBS and may initially deny coverage.

Z96. 82 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

DBS is FDA-approved and covered by most health insurance companies. Some insurance companies require prior authorization before having surgery, and some do not fully understand DBS and may initially deny coverage.

Such cortical stimulation placement would be coded with CPT codes 61850 (burr hold for cortical stimulation electrode) and 61860 (craniotomy or craniectomy for cortical stimulation electrode).

“Medicare coverage of deep brain stimulation by implantation of a stimulator device is not prohibited. Therefore, coverage of deep brain stimulation provided by an implanted deep brain stimulator is at carrier's discretion.”