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Code edit notification

Notification Number: 3418

Effective date: 2/1/2018

Notification date: 11/3/2017

Category: CPT

Topic: Electrical stimulators for pain and nausea/vomiting

Providers affected:

  • Inpatient/Outpatient Facilities
  • Physician/Health Care Providers
What is changing?

We will not reimburse charges for these electrical stimulator implantation procedures:

  • CPT code 64555 –  Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)
  • CPT code 64565 Percutaneous implantation of neurostimulator electrode array; neuromuscular
Why is Humana implementing this change?

Humana considers electrical stimulators to be experimental or investigational; therefore, they are not covered.

For more information, please review Humana's Electrical Stimulators for Pain and Nausea/Vomiting medical coverage policy. To locate the policy, go to Humana's Medical and Pharmacy Coverage Policies and search for “pain and nausea.”

Note: Humana's electrical stimulators for pain and nausea/vomiting policy is scheduled to be updated to indicate that the listed codes are not covered for treatment of pain and nausea/vomiting because the treatment is experimental or investigational. The update will be effective Feb. 1, 2018.

Impacted products

  • Select self-funded* products
  • Commercial fully insured products

Disclaimer

*All edits previously posted on Humana.com/providers for fully insured commercial Humana members may be applied to self-funded members, when requested by the self-funded group.