Does L8695 require prior authorization?

Yes, L8695 requires prior authorization (high confidence). At least one active policy explicitly requires prior authorization.

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`L8695`, External recharging system for battery (external) for use with implantable

HCPCS/CPT

Prior Authorization

Prior Auth Required

At least one active policy explicitly requires prior authorization (high confidence)

Documentation Required

Imaging and laboratory/biomarker data used in studies: brain CT or MRI, amyloid PET (e.g., florbetapir), cerebrospinal fluid (CSF) biomarkers (Aβ1-42, total tau, phospho-tau), and APOE ε4 genotyping when reported in trials.
For some interventional procedures/trials, pre-procedure evaluations included medical/neurological and psychological examinations, depression rating scales (e.g., Montgomery–Asberg Depression Rating Scale), and lumbar puncture with CSF analysis.
Documentation of prior/concurrent standard therapies (e.g., use of cholinesterase inhibitors and/or memantine) is often recorded in trials and may be relevant when considering investigational add-on therapies.
None specified in this policy document. (The CPB lists investigational/experimental treatments and codes not covered; it does not define separate documentation requirements for coverage of the listed items.)
None specified in this document excerpt.
Electrocardiogram (ECG) results to identify cardiac abnormalities (sinus bradycardia, signs of hypokalemia, arrhythmias) when clinically indicated.

Key Coverage Criteria

Covered indication: Implanted electrical spinal cord stimulators are medically necessary for CRPS, painful diabetic neuropathy, and failed back surgery syndrome when performed per FDA-labeled indications and cautions.
None specified. This Clinical Policy Bulletin addresses experimental treatments for Alzheimer's disease and lists treatments considered experimental and investigational (i.e., not established as effective) for this indication.
No explicit covered indications are stated in this document. The document discusses potential therapeutic use in the following conditions:
Alzheimer's disease (AD)
mild cognitive impairment (MCI)
amnestic MCI

20 Active Policies

EVICORE-HPLAN-CIGNA-AFCE721BA4F3, Cigna Comprehensive Code List - Effective 03/07/2026

EVICORE-HPLAN-CIGNA-844835841DE9, Cigna Commercial Interventional Pain Management Code List - Effective 03/07/2026

EVICORE-HPLAN-CIGNA_MEDICARE-47F76AA38AE6, Cigna Medicare Advantage Interventional Pain Management Code List - Effective 01/01/2025

UHC-POL-implanted-electrical-stimulator-spinal-cord, Implanted Electrical Stimulator for the Spinal Cord

AETNA-CPB-0788, Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments

AETNA-CPB-0511, Eating Disorders

AETNA-CPB-0011, Peripheral Electrical Nerve Stimulation for Pain

AETNA-CPB-0394, Epilepsy Surgery

AETNA-CPB-0614, Huntington's Disease

AETNA-CPB-0707, Headaches: Invasive Procedures

AETNA-CPB-0253, Vocal Cord Paralysis / Insufficiency Treatments

AETNA-CPB-0755, Motor Cortex Stimulation

AETNA-CPB-0378, NeuroControl Freehand System

AETNA-CPB-0362, Spasticity Management

AETNA-CPB-0406, Tinnitus Treatments

AETNA-CPB-0374, Trigeminal Neuralgia: Treatments

AETNA-CPB-0191, Vagus Nerve Stimulation

AMBETTER-CP.MP.203, Diaphragmatic/Phrenic Nerve Stimulation

BCBSIL-MED205.042, Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions

BCBSMT-MED205.042, Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions

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L8695, External recharging system for battery (external) for use with implantable

HCPCS/CPT

Prior Authorization

Prior Auth Required

At least one active policy explicitly requires prior authorization (high confidence)

Documentation Required

Imaging and laboratory/biomarker data used in studies: brain CT or MRI, amyloid PET (e.g., florbetapir), cerebrospinal fluid (CSF) biomarkers (Aβ1-42, total tau, phospho-tau), and APOE ε4 genotyping when reported in trials.
For some interventional procedures/trials, pre-procedure evaluations included medical/neurological and psychological examinations, depression rating scales (e.g., Montgomery–Asberg Depression Rating Scale), and lumbar puncture with CSF analysis.
Documentation of prior/concurrent standard therapies (e.g., use of cholinesterase inhibitors and/or memantine) is often recorded in trials and may be relevant when considering investigational add-on therapies.
None specified in this policy document. (The CPB lists investigational/experimental treatments and codes not covered; it does not define separate documentation requirements for coverage of the listed items.)
None specified in this document excerpt.
Electrocardiogram (ECG) results to identify cardiac abnormalities (sinus bradycardia, signs of hypokalemia, arrhythmias) when clinically indicated.

Key Coverage Criteria

Covered indication: Implanted electrical spinal cord stimulators are medically necessary for CRPS, painful diabetic neuropathy, and failed back surgery syndrome when performed per FDA-labeled indications and cautions.
None specified. This Clinical Policy Bulletin addresses experimental treatments for Alzheimer's disease and lists treatments considered experimental and investigational (i.e., not established as effective) for this indication.
No explicit covered indications are stated in this document. The document discusses potential therapeutic use in the following conditions:
Alzheimer's disease (AD)
mild cognitive impairment (MCI)
amnestic MCI

20 Active Policies

EVICORE-HPLAN-CIGNA-AFCE721BA4F3, Cigna Comprehensive Code List - Effective 03/07/2026

EVICORE-HPLAN-CIGNA-844835841DE9, Cigna Commercial Interventional Pain Management Code List - Effective 03/07/2026

EVICORE-HPLAN-CIGNA_MEDICARE-47F76AA38AE6, Cigna Medicare Advantage Interventional Pain Management Code List - Effective 01/01/2025

UHC-POL-implanted-electrical-stimulator-spinal-cord, Implanted Electrical Stimulator for the Spinal Cord

AETNA-CPB-0788, Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments

AETNA-CPB-0511, Eating Disorders

AETNA-CPB-0011, Peripheral Electrical Nerve Stimulation for Pain

AETNA-CPB-0394, Epilepsy Surgery

AETNA-CPB-0614, Huntington's Disease

AETNA-CPB-0707, Headaches: Invasive Procedures

AETNA-CPB-0253, Vocal Cord Paralysis / Insufficiency Treatments

AETNA-CPB-0755, Motor Cortex Stimulation

AETNA-CPB-0378, NeuroControl Freehand System

AETNA-CPB-0362, Spasticity Management

AETNA-CPB-0406, Tinnitus Treatments

AETNA-CPB-0374, Trigeminal Neuralgia: Treatments

AETNA-CPB-0191, Vagus Nerve Stimulation

AMBETTER-CP.MP.203, Diaphragmatic/Phrenic Nerve Stimulation

BCBSIL-MED205.042, Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions

BCBSMT-MED205.042, Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions

Have a follow-up question?

Ask Backwork about documentation requirements, denial risks, or coverage in your state.

Ask Backwork about L8695 Sign up free

`L8695`, External recharging system for battery (external) for use with implantable

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`L8695`, External recharging system for battery (external) for use with implantable

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

L8695, External recharging system for battery (external) for use with implantable

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

L8695, External recharging system for battery (external) for use with implantable

Prior Authorization

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`L8695`, External recharging system for battery (external) for use with implantable

`L8695`, External recharging system for battery (external) for use with implantable