61 commercial payer policies list L8687. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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61 policies from 15 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of L8687 |
|---|---|---|
| Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments | Feb 20, 2024 | Covered |
| Headaches: Invasive Procedures | Feb 20, 2024 | Covered |
| Motor Cortex Stimulation | Oct 6, 2023 | Covered |
| NeuroControl Freehand System | Jun 6, 2023 | Covered |
| Tinnitus Treatments | Feb 16, 2024 | Covered |
| Trigeminal Neuralgia: Treatments | Feb 15, 2024 | Covered |
| Vagus Nerve Stimulation | Feb 9, 2024 | Covered |
|---|
| Vocal Cord Paralysis / Insufficiency Treatments | May 5, 2023 | Covered |
|---|
| Policy | Effective | Status of L8687 |
|---|---|---|
| Diaphragmatic/Phrenic Nerve Stimulation | Not recorded | Covered |
| Fecal Incontinence Treatments | Not recorded | Covered |
| Gastric Electrical Stimulation | Not recorded | Covered |
| Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation | Not recorded | Covered |
| Urinary Incontinence Devices and Treatments | Not recorded | Covered |
| Vagus Nerve Stimulation | Not recorded | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Deep Brain Stimulation | Sep 15, 2026 | Covered |
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Sacral Nerve Neuromodulation/Stimulation | Dec 1, 2025 | Covered |
| Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation | Aug 1, 2026 | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Deep Brain Stimulation | Sep 15, 2026 | Covered |
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Sacral Nerve Neuromodulation/Stimulation | Dec 1, 2025 | Covered |
| Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation | Aug 1, 2026 | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Deep Brain Stimulation | Sep 15, 2026 | Covered |
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Sacral Nerve Neuromodulation/Stimulation | Dec 1, 2025 | Covered |
| Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation | Aug 1, 2026 | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Deep Brain Stimulation | Sep 15, 2026 | Covered |
| Implantable Peripheral Nerve Stimulation for Chronic Pain Conditions | Jan 1, 2026 | Covered |
| Occipital Nerve Stimulation | Nov 15, 2025 | Covered |
| Sacral Nerve Neuromodulation/Stimulation | Dec 1, 2025 | Covered |
| Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion (DRG) Stimulation | Aug 1, 2026 | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Deep Brain and Cortical Stimulation – Surest Medical Policy | Apr 1, 2026 | Covered |
| Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation | Oct 1, 2026 | Covered |
| Implanted Electrical Stimulator for the Spinal Cord | Jan 1, 2026 | Covered |
| Sacral Nerve Stimulation for Urinary and Fecal Indications | Jan 1, 2026 | Covered |
| Vagus and External Trigeminal Nerve Stimulation | Jan 1, 2026 | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Deep Brain and Cortical Stimulation | Feb 1, 2026 | Covered |
| Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation | Oct 1, 2026 | Covered |
| Implanted Electrical Stimulator for the Spinal Cord | Jan 1, 2026 | Covered |
| Sacral Nerve Stimulation for Urinary and Fecal Indications | Jan 1, 2026 | Covered |
| Vagus and External Trigeminal Nerve Stimulation | Jan 1, 2026 | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Deep Brain and Cortical Stimulation | Feb 1, 2026 | Covered |
| Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation | Oct 1, 2026 | Covered |
| Implanted Electrical Stimulator for the Spinal Cord | Jan 1, 2026 | Covered |
| Sacral Nerve Stimulation for Urinary and Fecal Indications | Jan 1, 2026 | Covered |
| Vagus and External Trigeminal Nerve Stimulation | Jan 1, 2026 | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Cigna Commercial Interventional Pain Management Code List - Effective 03/07/2026 | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List - Effective 03/07/2026 | Mar 7, 2026 | Prior auth required |
| Diaphragmatic/Phrenic Nerve Stimulation | Jul 15, 2026 | Covered with conditions |
| Headache, Occipital, and/or Trigeminal Neuralgia Treatment | Jun 15, 2026 | Not covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Gastric Electrical Stimulation | Jul 1, 2026 | Covered |
| Occipital Nerve Stimulation | Jun 1, 2026 | Covered |
| Sacral Nerve Neuromodulation (Stimulation) for Pelvic Floor Dysfunction | Dec 1, 2025 | Covered |
| Vagus Nerve Stimulation | Aug 1, 2026 | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Deep Brain Stimulation and Responsive Neurostimulation | Oct 1, 2026 | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Interventional Pain Management | Not recorded | Covered |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Cigna Medicare Advantage Interventional Pain Management Code List - Effective 01/01/2025 | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of L8687 |
|---|---|---|
| Deep Brain and Responsive Cortical Stimulation | Not recorded | Covered |