Upcoming changes to billing requirements for deep brain stimulation​

October 26, 2020

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 policy

For more information, including a complete list of medical necessity criteria for DBS and the updated billing requirements, please review AmeriHealth Medical Policy #11.15.20p: Deep Brain Stimulation (DBS), which was posted as a Notification on October 26, 2020, and will go into effect January 25, 2021.

To view the policy Notification, visit the Active Notifications section of our Medical and Cl​aim Payment Policy Portal

CPT Copyright 2017 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.​