The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Occipital nerve stimulation for intractable chronic migraine.

Description

A migraine is a severe headache usually felt as a throbbing pain at the front or on one side of the head. Some people also have other symptoms, such as nausea and sensitivity to light. Occipital nerve stimulation involves implanting electrodes, an impulse generator and connecting insulated wires under the skin. The electrodes are implanted near the occipital nerve located just beneath the skin at the back of the head and the impulse generator is usually implanted at a site in the torso. The patient uses a remote control to deliver electrical impulses to the occipital nerve with the aim of masking the pain.

Coding recommendations

Stage 1

A70.4 Insertion of neurostimulator electrodes into peripheral nerve

Y70.5 Temporary operations

Y70.3 First stage of staged operations NOC

Y53.4   Approach to organ under fluoroscopic control (if fluoroscopic control has been used)

Z92. 1 Head  NEC

Stage 2

A70.1 Implantation of neurostimulator into peripheral nerve

Y71.1 Subsequent stage of staged operations NOC

Y53.4   Approach to organ under fluoroscopic control (if fluoroscopic control has been used)

Z92.1 HeadNEC

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