Deep Brain, Motor Cortex and Responsive Cortical Stimulation - (0184)

Cigna covers DBS for medically intractable primary dystonia (age ≥7 per FDA HDE), Parkinson disease (levodopa‑responsive with intractable motor fluctuations/dyskinesia and no significant cognitive/medical/surgical contraindication), essential tremor per FDA indications, and DBS for adult epilepsy (≥18) with partial‑onset seizures refractory to ≥3 medications; RNS is covered for adults (≥18) with localized partial‑onset seizures refractory to ≥2 medications who average ≥3 disabling seizures/month and are not candidates for resection or VNS, while motor cortex stimulation and DBS for non‑FDA indications (e.g., OCD) are considered experimental/not medically necessary. Replacements of generators/leads/programmers/monitors are covered only if the patient still meets the original device criteria and the existing component is out of warranty and cannot be repaired, and all uses must follow FDA/HDE labeling with appropriate documentation (age, medication failures, levodopa‑responsiveness/localization, and absence of contraindications).