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Wiki TMS Medical Necessity Codes

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tbattle511

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Hello All,

I need to know the medical necessity codes for CPT's 90868, 90869 and 90867 ? Can anyone help me please ?

Thank you.
 
Here is the Link for UHC payer policy for TMS. Most payers share this protocol to follow when providing TMS, including prior failed therapies.

https://www.uhcprovider.com/content/dam/.../transcranial-magnetic-stimulation.pdf

The only two covered diagnosis are:
Major Depressive Disorder - Single Episode, Severe, Without psychotic features F32.2
Major Depressive Disorder - Recurrent Episode, Severe, Without psychotic features F33.2

I hope that helps!
 
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