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 refractory chronic pain syndromes (excluding headache).

NICE has also published guidance on deep brain stimulation for intractable trigeminal autonomic cephalalgias (NICE interventional procedure guidance 381, March 2011).


Refractory chronic pain syndromes are characterised by pain that persists despite treatment and for longer than expected. Causes are varied and pain can occur anywhere in the body. Chronic pain can be debilitating and have a significant impact on a person’s quality of life. A variety of treatments can be used depending on the cause and precise symptoms. This procedure aims to treat chronic pain that does not respond to other treatments. It involves stimulating a precise area of the brain using an electrode.

Coding recommendations

A09.1 Implantation of neurostimulator into brain

Y53.3 Approach to organ under computed tomography scan control

Includes: Approach to organ under stereotactic control


Y53.7 Approach to organ under magnetic resonance imaging control

Appropriate ICD-10 codes are assigned in addition depending on the specific site of the pain, if the site of the pain is not known ICD-10 code R52.2 Other chronic pain is assigned.

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