SURG.00112 Implantation of Occipital, Supraorbital or Trigeminal Nerve Stimulation Devices (and Related Procedures)

This policy addresses implantation of peripheral or cranial nerve stimulation devices targeting the occipital, supraorbital, or trigeminal nerves, including trial stimulation, permanent implantation, and related procedures/hardware. Anthem considers these services investigational and not medically necessary for all indications; therefore, they are not covered. There are no covered indications or exceptions—noncoverage applies regardless of diagnosis (e.g., migraine, cluster headache, trigeminal neuralgia) and includes associated leads, pulse generators, and revisions.

"Implantation of an occipital nerve stimulation device (and related procedures) is consideredinvestigational and not medicallynecessaryfor all indications."

Sign up to see full coverage criteria, indications, and limitations.