CommercialBilling CodesMedium impact
11.15.16x, Vagus Nerve Stimulation (VNS)
Independence Blue Cross·Neurology, Neurosurgery, Psychiatry +1 more·Medical Policy
Effective date
Oct 1, 2026
We identified it
Oct 2, 2026
Summary
Independence Blue Cross added five new CPT codes (1057T, 1058T, 1059T, 1060T, 1061T) to policy 11.15.16x for Vagus Nerve Stimulation, all classified as Experimental/Investigational and therefore not covered. This is a coding update that clarifies billing requirements for VNS procedures effective October 1, 2026. Billing teams must ensure these codes are not submitted for coverage or are submitted with appropriate denial expectations.
Action Required
By September 15, 2026: Billing team must update system billing rules to classify CPT codes 1057T, 1058T, 1059T, 1060T, and 1061T as Experimental/Investigational for Independence Blue Cross Commercial plans. Configure system to deny claims or require provider notification that these codes are not covered under this policy. Add internal documentation noting that implantable VNS is only medically necessary for medically refractory seizures; all other indications (depression, obesity, OCD, tremor, etc.) are non-covered. Update claim scrubbers to prevent submission of these codes for non-seizure diagnoses. Educate providers and coders that CPT codes 0908T-0912T remain covered only for seizure-related indications with appropriate ICD-10 codes (G40.x series). Failure to implement these rules will result in claim denials and potential billing compliance issues.