Wiki Use of Z45.42 as principal diagnosis for the adjustment of a neurostimulator

[atxn1969]

Does anyone have insight on the use of ICD-10 Z45.42 as a principal diagnosis for a vagus nerve stimulator adjustment? The reason for the encounter is the adjustment of the neurostimulator for a patient who has (or had intractable seizures). CMS only covers intractable partial seizure diagnoses but if the device already implanted and is working I would believe you would use Z45.42 in position 1 and the epilepsy diagnosis code in position 2. The problem is if the patient is no longer intractable then you can't use a covered CMS diagnosis code to manage patients who have controlled their seizures though the use of an already implanted VNS Therapy system. I would be interested in what the AAPC membership thinks about the issue. Many thanks!

 

[daedolos]

Would the same principal be applied as is applied to DM and whether or not it what degree of control is established? In any case, the proper DM Dx is applied even if the patient is on insulin or other measures. Would that rationale stand for your case?

Peace
?_?