ND Committee Review
Internal Medical Policy Committee 1-22-2020
- Removed Deep Brain Stimulation and made it, it's own policy
Internal Medical Policy Committee 11-19-2020 Revision of policy
- Expanded indications; definitions of indications; and E/I statements; and
- Removed Procedure Codes; and
- Added Procedure Codes; and
- Added Diagnosis codes: G47.31; G47.34; G47.35; G47.36; and G47.37 for Phrenic Nerve Stimulation (64575, 64580, 64585, 64590,64595, L8680, L8682, L8683, L8685, L8686, L8687, L8688, L8689, L8696, 0424T, 0425T, 0426T, 0427T, 0428T, 0429T, 0430T, 0431T, 0432T, 0433T, 0434T, 0435T, 0436T)
Internal Medical Policy Committee 1-19-2021 Coding update:
- Removed procedure codes 64561 and 64581; and
- Added procedure codes 64999
Internal Medical Policy Committee 3-17-2021 Coding update - Effective April 01, 2021
- Added Procedure code K1020
Internal Medical Policy Committee 9-21-2021 Coding update Effective October 01, 2021 :
- Added Procedure codes: 64555; 64999; 95976; E1399; and
- Added Diagnosis codes: G43.001; G43.009; G43.011; G43.019; G43.101; G43.109; G43.111; G43.119; G44.021; G44.029; G44.001; and G44.009; and
- Revised language for clarity
Internal Medical Policy Committee 11-23-2021
- Added statement regarding PENFS device
Internal Medical Policy Committee 7-21-2022 Revision with Coding - Effective July 01, 2022
- Added Procedure code 0720T
- Revision that is Effective September 05, 2022
- Revision of criteria throughout policy
- Added Procedure codes 0278T; 95977; K1016; K1017; L8679; and L8695
- Added Diagnosis code Z45.42
- Added s ubtitle ' Implantable Peripheral Nerve Stimulator'
to that section of policy.
Internal Medical Policy Committee 11-29-2022 Coding update - Effective January 01, 2023
- Added Procedure code C1826
Internal Medical Policy Committee 3-23-2023 Coding update - Effective April 01, 2023
- Added Procedure code L8678
Internal Medical Policy Committee 1-16-2024 Coding update - Effective January 01, 2024
- Removed procedure codes 0424T, 0425T, 0426T, 0427T, 0428T, 0429T, 0430T, 0431T, 0432T, 0433T, 0434T, 0435T, 0436T, K1016, K1017, K1018, K1019, K1020; and
- Added procedure codes 33276, 33277, 33278, 33279, 33280, 33281, 33287, 33288, 64596, 64597, 64598, 93151, 93152, 93153, A4541,A4542, E0733, E0734, E0735.