The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Vagus nerve stimulation for treatment-resistant depression.


Depression is associated with feelings of sadness, despair, helplessness, hopelessness and lack of interest in life. People with severe depression may be unable to eat or sleep or to take part in social activities, and they may become completely withdrawn. Vagus nerve stimulation aims to improve mood regulation and reduce depression by stimulating the nerve in the neck that carries signals to the brain areas involved. A generator implanted under the skin in the chest area is used to provide electrical stimulation to the nerve.

Coding recommendations

A33.1 Introduction of neurostimulator into cranial nerve
Z04.4 Vagus nerve (x)

In addition an ICD-10 code from category F32 Depressive episode or F33 Recurrent depressive disorder is assigned.

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