Reimbursement and Coding

For Abbott neuromodulation therapies

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doctor hands typing
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Coding guides and resources

Abbott values the work of our partners in healthcare and wants to help make their lives easier. Here are relevant documents, reimbursement guides, coding and payment overviews, Medicare National Coverage Determinations, and final rule details for Abbott products. E-mail to connect with an Abbott Neuromodulation reimbursement specialist.

The links below reflect the latest coding information for Abbott Neuromodulation products.

Chronic Pain Coding Guide (PDF; 1MB) Medicare coding guide for spinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRG)

Radio Frequency Ablation (RFA) Coding Guide (PDF; 800KB) Medicare coding guide for radio frequency ablation (RFA)

Deep Brain Stimulation (DBS) Coding Guide (PDF; 1MB) Medicare coding guide for deep brain stimulation (DBS)

Neuromodulation HCPCS Device Category C-Codes (PDF; 2MB) Current reimbursement Healthcare Procedural Coding System (HCPCS) Neuromodulation Category Codes

Centers for Medicare and Medicaid Services (CMS)

Medicare National Coverage Determination for SCS/DRG Medicare national coverage determination manual for dorsal column stimulators

Medicare Coverage Database Search Medicare Local Coverage Determinations for SCS/DRG/RFA procedures

Medicare National Coverage Determination for DBS Medicare national coverage determination manual for deep brain stimulation

Medicare Physician Fee Schedule

Medicare Learning Network Matters Articles

Medicare Coverage Database

MedPac Publications: Payment Basics

Patient therapy access (PTA)

Abbott has a team of patient therapy access specialists to assist accounts and a reimbursement hotline to answer coding questions. Call 1-800-727-7846 or email them at PTherapyAccess@abbott.com.

Replacement equipment

If you require the replacement of external parts of your system, please contact Abbott Technical Services at 1-800-727-7846 to see if your equipment is covered under warranty.

If your equipment is not covered by warranty, the Technical Services staff will give you the option of having Continuum Services facilitate your equipment replacement. Non-warranty replacement equipment requires a signed prescription. Continuum Services will work with the patient, the authorized prescriber, and the insurance company to obtain the prescription and arrange for insurance billing. For more information, visit Continuum online or call 877-217-1485. Email inquiries may also be sent to NMD@abbott.com.

HE&R disclaimer

This material and the information contained herein is for general information purposes only and is not intended, and does not constitute, legal, reimbursement, business, clinical, or other advice. Furthermore, it is not intended to and does not constitute a representation or guarantee of reimbursement, payment, or charge, or that reimbursement or other payment will be received. It is not intended to increase or maximize payment by any payer. Similarly, nothing in this material should be viewed as instructions for selecting any particular code, and Abbott does not advocate or warrant the appropriateness of the use of any particular code. The ultimate responsibility for coding and obtaining payment/reimbursement remains with the customer. This includes the responsibility for accuracy and veracity of all coding and claims submitted to third-party payers. In addition, the customer should note that laws, regulations, and coverage policies are complex and are updated frequently, and, therefore, the customer should check with its local carriers or intermediaries often and should consult with legal counsel or a financial, coding, or reimbursement specialist for any questions related to coding, billing, reimbursement, or any related issues. This material reproduces information for reference purposes only. It is not provided or authorized for marketing use.

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