Does C1822 require prior authorization?

Yes, C1822 requires prior authorization (high confidence). Code explicitly requires prior authorization.

`C1822`, Generator, neurostimulator (implantable), high frequency, with rechargeable

HCPCS/CPT

Prior Auth Required

Code explicitly requires prior authorization (high confidence)

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.
Medical necessity documentation must be submitted at request time.
Documentation must show conservative management including physical therapy and at least one complementary strategy.
Clinical reevaluation should occur absent contraindications and should include physical examination in most cases.

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
Tremor from Parkinson’s disease cannot be controlled pharmacologically.

ANTHEM-SURG.00026, SURG.00026 Deep Brain, Cortical, and Cerebellar Stimulation

BCBSIL-MED205.042, Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions

BCBSIL-SUR712.009, Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation

BCBSMT-MED205.042, Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions

BCBSMT-SUR712.009, Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation

BCBSNM-MED205.042, Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions

BCBSNM-SUR712.009, Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation

BCBSOK-MED205.042, Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions

CARELON-interventional-pain-management-2024-01-01, Interventional Pain Management

CARELON-interventional-pain-management-2024-06-30-for-ohio-medicaid, Interventional Pain Management

CARELON-interventional-pain-management-2025-07-26, Interventional Pain Management

BCBSOK-SUR712.009, Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation

REGENCE-SUR45a, Spinal Cord and Dorsal Root Ganglion Stimulation

CIGNA-0063, Headache, Occipital, and/or Trigeminal Neuralgia Treatment

EVICORE-HPLAN-CIGNA-1815296EE67F, Cigna Comprehensive Code List - Effective 03/07/2026

EVICORE-HPLAN-CIGNA-844835841DE9, Cigna Commercial Interventional Pain Management Code List - Effective 03/07/2026

Ask Verity about documentation requirements, denial risks, or coverage in your state.

C1822, Generator, neurostimulator (implantable), high frequency, with rechargeable

HCPCS/CPT

Prior Auth Required

Code explicitly requires prior authorization (high confidence)

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.
Medical necessity documentation must be submitted at request time.
Documentation must show conservative management including physical therapy and at least one complementary strategy.
Clinical reevaluation should occur absent contraindications and should include physical examination in most cases.

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
Tremor from Parkinson’s disease cannot be controlled pharmacologically.