The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on deep brain stimulation for tremor and dystonia (excluding Parkinson's disease).


This procedure involves inserting very fine needles into the brain through small holes made in the skull to determine the exact position of the nucleus, which may be different in each patient. This part of the procedure is usually carried out under local anaesthetic. Once the nucleus is identified, a permanent electrode is placed into it. Under general anaesthetic, this electrode is then connected to a pulse generator, which is implanted subcutaneously on the anterior chest wall.

Coding recommendations

A09.1 Implantation of neurostimulator into brain


A09.5 Insertion of neurostimulator electrodes into the brain

Y70.5 Temporary operations

Note: In a case where the electrode leads are implanted temporarily, to test whether the intervention is likely to be effective, but the pulse generator device is not implanted under the patient’s skin, a code for "insertion of neurostimulator electrodes" is utilised. The code A09.1 Implantation of neurostimulator into brain is for when the device is implanted permanently under the skin.