C1822 — Generator, neurostimulator (implantable), high frequency, with rechargeable battery and charging system
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Documentation Required
- When billing, providers must use the most appropriate codes as of the effective date of the submission. Claims submitted for services that are not accompanied by covered code(s) under the applicable Coverage Policy will be denied as not covered.
- Reimbursement is not allowed for services when billed for conditions or diagnoses that are not covered under this Coverage Policy (see 'Coding Information').
- No specific clinical documentation requirements (e.g., required test results, prior-treatment trial documentation, or specific notes) are specified in this policy beyond standard claims submission with appropriate diagnosis and procedure codes and adherence to the applicable benefit plan document.
- Documented evidence of failure, contraindication or intolerance to all suitable medical and pharmacological management prior to implantable VNS (as implied by: "...when there is failure, contraindication or intolerance to all suitable medical and pharmacological management").
Key Coverage Criteria
- Vagus nerve stimulation (VNS) with an implantable vagus nerve stimulator is considered medically necessary for the treatment of medically intractable seizures when there is failure, contraindication or intolerance to all suitable medical and pharmacological management.
- Refractory to two (2) or more antiepileptic medications;and
- Unilateral or bilateral deep brain stimulation is consideredmedically necessaryfor individuals with Parkinson’s disease when the following criteria have been met:
- A minimal score of 30 points on the motor portion of the Unified Parkinson’s Disease Rating Scale (UPDRS) when the individual has been without medication for 12 hours;and
- Either of the following:Motor complications of therapy that cannot be controlled pharmacologically;orTremor from Parkinson’s disease cannot be controlled pharmacologically.
- Motor complications of therapy that cannot be controlled pharmacologically;or
8 Active Policies
CIGNA-0063 — Headache, Occipital, and/or Trigeminal Neuralgia Treatment - (0063)
CIGNA-VNS — Vagus Nerve Stimulation (VNS) - (0350)
ANTHEM-SURG.00026 — SURG.00026 Deep Brain, Cortical, and Cerebellar Stimulation
CARELON-interventional-pain-management-2025-07-26 — Interventional Pain Management
BCBSIL-MED205.042 — Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions
Related Codes
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