Effective January 25, 2021, claims submitted for deep brain stimulation (DBS) with any of the following CPT® codes
must include a primary ICD-10 diagnosis code that represents the member's diagnosis:
- 61850
- 61860
- 61863
- 61864
- 61867
- 61868
- 61886
In accordance with our policy on DBS, this service is considered Medically Necessary for essential tremor, Parkinson's disease, dystonia, torticollis, or obsessive-compulsive disorder. Claims submitted
without an appropriate diagnosis code will
not be covered.
Updated policies
For more information, including a complete list of medical necessity criteria for DBS and the updated billing requirements, please review the following Independence policies, which were posted as Notifications on October 26, 2020, and will go into effect
January 25, 2021:
-
Commercial: #11.15.20p: Deep Brain Stimulation (DBS)
-
Medicare Advantage: #MA11.005d: Deep Brain Stimulation (DBS)
To view these policy Notifications, visit the Active Notifications section of our
Medical and Claim Payment Policy Portal.
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