Diagnosis Code for “End of Life” DBS Battery

Question:

What would be the appropriate diagnosis code (ICD-10-CM) for “end of life battery” when we have to change the generator in a deep brain stimulator patient. I have gotten mixed responses previously whether or not to bill “mechanical complication” vs “encounter for adjustment”. Or are both of these incorrect?

Answer:

We recommend using the original diagnosis for why the deep brain stimulator was placed in the first place (e.g., Parkinson’s). It is expected that a battery will last only so long so replacing it is not considered a “complication” when replacement is needed. You could also report Z45.49 (Encounter for adjustment and management of other implanted nervous system device) as a secondary diagnosis code but it would not be the primary diagnosis. The primary diagnosis is the patient’s condition that warranted the neurostimulator. This advice actually applies to spinal cord stimulator and vagus nerve stimulator battery replacement.

*This response is based on the best information available as of 12/19/19.