Vagus Nerve Stimulation (VNS): CPT Codes 61885 and 61888 National Coverage Determination (NCD) Update
States Applicable to Alert:
Northern and Southern
California
Background Information:
Procedure codes in the vagus nerve stimulation national coverage determiniation were denying in error. CPT codes 61885 and 61888 are being removed from coverage.
Applies To Procedure Code(s):
61885 64585 95975
61888 95970
64573 95974
Remark / Reason Codes:
50 - These are non-covered services because this is not deemed a medical necessity by the payer.
N115 - This decision was based on a Local Medical Review Policy (LMRP) or Local Coverage Determination (LCD). An LMRP/LCD provides a guide to assist in determining whether a particular item or service is covered.
A copy of this policy is available at www.cms.hhs.gov/mcd. If you do not have Web access, you may contact the contractor to request a copy of the LMRP/LCD.
MAC Action:
A mass adjustment was completed on April 2, 2009, with 27 claims adjusted in SCA and 23 claims in NCA.
Provider Action: No action required.
Date Reported: March 6, 2009
Date Resolved: April 2, 2009