![]() Vagus nerve stimulation also may be helpful for people who haven't responded to depression treatments. Vagus nerve stimulation also is considered for people with generalized epilepsy. ![]() Have seizures that aren't well-controlled with medicines.In focal epilepsy, the brain activity that causes seizures happens in one area of the brain. The FDA has approved vagus nerve stimulation for people who: Vagus nerve stimulation may be an option to reduce seizures in people who haven't achieved control with medicines. EpilepsyĪbout one-third of people with epilepsy don't fully respond to anti-seizure drugs. In vagus nerve stimulation, an implanted pulse generator and lead wire stimulate the vagus nerve, which leads to stabilization of electrical activity in the brain.Ī variety of conditions can be treated with implantable vagus nerve stimulation devices. Current research is looking at the potential benefits of the therapy for rheumatoid arthritis, inflammatory bowel disease, bipolar disorder, obesity and Alzheimer's disease. Researchers are studying vagus nerve stimulation as a potential treatment for a variety of other conditions. The stimulation blocks pain signals to prevent or relieve head pain. This device stimulates the vagus nerve when it's held against the skin of the neck. The FDA has approved a noninvasive vagus nerve stimulation device to treat cluster headaches and migraine in the United States. There also are newer, noninvasive vagus nerve stimulation devices that don't require surgery. The right vagus nerve isn't typically used because stimulation is more likely to affect the function of the heart. When activated, the device causes electrical signals to be sent along the left vagus nerve to the brainstem, which then affects the brain. A wire is threaded under the skin connecting the device to the left vagus nerve. These devices are surgically implanted under the skin of the chest. This can help the person regain function. When someone has trouble using their hand or arm after a stroke, the stimulation helps create new pathways in the brain as the person performs exercises. The device works by sending stimulation to areas of the brain that lead to seizures and affect mood.Īnother vagus nerve stimulation device is FDA approved to be used with rehabilitation when recovering from a stroke. An implantable vagus nerve stimulator has been approved by the Food and Drug Administration (FDA) to treat epilepsy and depression. Medicare Claims Processing Manual, Chapter 32- Billing Requirements for Special Services, §200- Billing Requirements for Vagus Nerve Stimulation (VNS)ġ0.Vagus nerve stimulation can be done in many ways with many devices. Medicare National Coverage Determination (NCD) Manual, Chapter 1, Part 2, 160.18- Vagus Nerve Stimulation (VNS).ĩ. Medicare Program Integrity Manual, Chapter 3- Verifying Potential Errors and Taking Corrective Actions, §§3.1- 3.6.6Ĩ. 42 CFR §405.986- Good Cause for Reopeningħ. 42 CFR §405.980- Reopening of Initial Determinations, Redeterminations, Reconsiderations, Decisions, and Reviews, (b)- Timeframes and Requirements for Reopening Initial Determinations and Redeterminations Initiated by a Contractor and (c)- Timeframes and Requirements for Reopening Initial Determinations and Redeterminations Requested by a PartyĦ. 42 CFR §405.930- Failure to Respond to Additional Documentation Requestĥ. Social Security Act (SSA), Title XVIII- Health Insurance for the Aged and Disabled, Section 1833(e)- Payment of BenefitsĤ. Social Security Act (SSA), Title XVIII- Health Insurance for the Aged and Disabled, Section 1862(a)(1)(A)- Exclusions from Coverage and Medicare as a Secondary PayerĢ. Medical documentation will be reviewed to determine if the vagus nerve stimulator meets Medicare coverage criteria and/or is reasonable and necessary.ġ. VNS for treatment of resistant depression is non-covered when furnished outside of a CMS-approved CED study. VNS is reasonable and necessary for treatment-resistant depression through Coverage with Evidence Development (CED). VNS is not reasonable and necessary for all other types of seizure disorders which are medically refractory and for whom surgery is not recommended or for whom surgery has failed. Vagus Nerve Stimulation (VNS) is reasonable and necessary for patients with medically refractory partial onset seizures for whom surgery is not recommended or for whom surgery has failed.
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