Common Coding Options for VNS Therapy (Vagus Nerve Stimulation)
ICD-9-CM-DIAGNOSIS CODES
345.41 Partial epilepsy with impairment of consciousness, with intractable epilepsy
345.51 Partial epilepsy without mention of impairment of consciousness, with intractable epilepsy
780.39 Other convulsions
ICD-9-CM PROCEDURE CODES – IMPLANTATION, REPLACEMENT, OR REMOVAL
04.92 Implantation or replacement of peripheral neurostimulator lead(s)
86.94 Insertion or replacement of a 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
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 (e.g., 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 (i.e., cranial nerve, peripheral nerve, autonomic nerve, neuromuscular) neurostimulator pulse generator/transmitter, without reprogramming
95974 Electronic analysis of implanted neurostimulator pulse generator system (e.g., 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, with or without nerve interface testing, first hour
95975 Electronic analysis of implanted neurostimulator pulse generator system (e.g., 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
HOSPITAL OUTPATIENT CATEGORY C - CODES (MEDICARE ONLY)
C1767 Generator, Neurostimulator
C1778 Lead, Neurostimulator
AMBULATORY PAYMENT CLASSIFICATION (HOSPITAL OUTPATIENT – MEDICARE ONLY)
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 Pulse Generators → 95974, 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 toll free Reimbursement Hotline at
1-888-508-8082 or email reimbursement-hotline@cyberonics.com
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