To ensure that a patient meets the medically necessary policy criteria, or to find out if prior authorization/pre-determination is required, please contact the patient’s payer directly. Medtronic provides this information for your convenience only.
It is the responsibility of the provider to determine coverage and submit appropriate codes, modifiers, and charges for the services rendered. The information below provides assistance for FDA approved or cleared indications.
The coding includes information on the diagnosis and procedure codes applicable to all sites-of-service to be used when billing, along with Medicare National Average payment rates. For specific coding assistance with your facility, please contact your local Health Economics Manager.
View our reimbursement guide to see a list of commonly billed hospital, physician, and ASC codes.
Medtronic provides this information for your convenience only. It is not intended as a recommendation regarding clinical practice. It is the responsibility of the provider to determine coverage and submit appropriate codes, modifiers, and charges for the services rendered. The Reimbursement Guide that can be downloaded above, provides assistance for FDA approved or cleared indications (e.g., instructions for use, operator’s manual, or package insert). Consult with your billing advisors or payers for advice on handling such billing issues. Some payers may have policies that make it inappropriate to submit claims for such items or related service. Contact your Medicare contractor or other payer for interpretation of coverage, coding, and payment policies.
Humanitarian Device: Medtronic DBS Therapy has been authorized by Federal Law for the use as an aid in the management of chronic, intractable (drug refractory) primary dystonia and for people with chronic, severe, treatment-resistant obsessive-compulsive disorder. The effectiveness of this device for these uses has not been demonstrated.