Common Coding Options for VNS Therapy (Vagus Nerve Stimulation)

ICD-9-CM-DIAGNOSIS CODES
345.41 Localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures, with intractable epilepsy
345.51 Localization-related (focal) (partial) epilepsy and epileptic syndromes with simple partial seizures, with intractable epilepsy

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

Revision or Removal
64585 Revision or removal of peripheral neurostimulator electrodes
61888Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array

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 generator/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)
040 Peripheral/Cranial Nerve and Other Nervous System Procedures with MCC
041 Peripheral/Cranial Nerve and Other Nervous System Procedures with CC or Peripheral Neurostimulator
042 Peripheral/Cranial Nerve and Other Nervous System Procedures without CC/MCC

HOSPITAL OUTPATIENT CATEGORY C - CODES (MEDICARE ONLY)
C1767 Generator, neurostimulator (implantable), nonrechargeable
C1778 Lead, neurostimulator (implantable)

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

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.

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