Vagus Nerve Stimulation

Aetna covers implanted vagus nerve stimulators (including electronic analysis, revisions and replacements if the original system met medical-necessity criteria and is not under warranty) as medically necessary DME to shorten or reduce seizures in members with focal seizures or Lennox‑Gastaut syndrome who remain refractory to optimal anti‑epileptic medications and/or surgical intervention or have debilitating medication side effects, provided there is no history of a bilateral or left cervical vagotomy. Transcutaneous VNS and VNS for chronic migraine prevention, depression (CMS non‑coverage), myocardial ischemia‑reperfusion injury and numerous other indications listed in the policy are considered experimental/investigational and excluded.

"ICD-10 exclusions: G44."

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