- Surgery of the aortic arch, its branch vessels or thoracic aorta, including internal carotid artery surgery, when there is risk of cerebral ischemia.
- Resection of epileptogenic brain tissue or tumor.
- Protection of cranial nerves:
- Resection of tumors involving the cranial nerves.
- Microvascular decompressive surgeries (i.e., trigeminal neuralgia surgery).
- Skull base surgery in the vicinity of the cranial nerves and surgeries of the foramen magnum.
- Cavernous sinus tumors.
- Oval or round window graft.
- Endolymphatic shunt for Meniere’s disease.
- Vestibular section for vertigo.
- Correction of scoliosis or deformity of spinal cord involving traction on the cord.
- Decompressive procedures on the spinal column or cauda equina performed for myelopathy or claudication where the function of spinal cord or spinal nerves is at risk.
- During placement of internal spinal fixation devices, i.e., pedicle screws where nervous system function is at risk.
- Spinal cord tumors and spinal fractures (with the risk of cord compression).
- Neuromas of peripheral nerves or brachial plexus when there is risk to major sensory or motor nerves.
- Surgery or embolization for intracranial Arterio-Venous Malformations (AVMs).
- Embolization of bronchial artery AVMs or tumors.
- Arteriography during which there is a test occlusion of the carotid artery.
- Circulatory arrest with hypothermia.
- Distal aortic procedures when there is risk of ischemia to spinal cord.
- Leg lengthening procedures when there is traction on the sciatic nerve.
- Safe and effective.
- Not experimental or investigational (exception: routine costs of qualifying clinical trial services with dates of service on or after September 19, 2000, which meet the requirements of the clinical trials NCD are considered reasonable and necessary).
- Appropriate, including the duration and frequency that is considered appropriate for the service, in terms of whether it is:
- Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition or to improve the function of a malformed body member.
- Furnished in a setting appropriate to the patient’s medical needs and condition.
- Ordered and furnished by qualified personnel.
- One that meets, but does not exceed, the patient’s medical need.
- At least as beneficial as an existing and available medically appropriate alternative.
Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book. The American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) require the use of short CPT descriptors in policies published on the Web.
Intraop nerve test add-on
Unlisted neurological procedure