ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 Z45.42

Billable / Specific

Encounter for adjustment and management of neurostimulator

Z45
Block
6
Synonyms
35
LCDs
3
Payer Policies
8
Linked CPTs

About ICD-10-CM Z45.42

ICD-10-CM code Z45.42 represents Encounter for adjustment and management of neurostimulator. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z45). The 2026 edition of ICD-10-CM Z45.42 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under Z45.42. Per CMS ICD-10-CM Tabular 2026.

  • Encounter for adjustment and management of brain neurostimulator
  • Encounter for adjustment and management of gastric neurostimulator
  • Encounter for adjustment and management of peripheral nerve neurostimulator
  • Encounter for adjustment and management of sacral nerve neurostimulator
  • Encounter for adjustment and management of spinal cord neurostimulator
  • Encounter for adjustment and management of vagus nerve neurostimulator

Medicare LCD Coverage for Z45.42

Local Coverage Determinations (LCDs) from CMS MACs that list Z45.42 as a covered diagnosis.

35 LCDs

Showing top 10 of 35 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Article ID: 59332, Effective: 2024-01-01 00:00:00, 45 covered, 0 non-covered
CPT C1897 →
CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Article ID: 59332, Effective: 2024-01-01 00:00:00, 45 covered, 0 non-covered
CPT C1778 →
CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Article ID: 59332, Effective: 2024-01-01 00:00:00, 45 covered, 0 non-covered
CPT 95970 →
CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Article ID: 59332, Effective: 2024-01-01 00:00:00, 45 covered, 0 non-covered
CPT L8678 →
CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Article ID: 59332, Effective: 2024-01-01 00:00:00, 45 covered, 0 non-covered
CPT C1820 →
CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Article ID: 59332, Effective: 2024-01-01 00:00:00, 45 covered, 0 non-covered
CPT A4290 →
CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Article ID: 59332, Effective: 2024-01-01 00:00:00, 45 covered, 0 non-covered
CPT C1883 →
CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Article ID: 59332, Effective: 2024-01-01 00:00:00, 45 covered, 0 non-covered
CPT 95971 →
CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Article ID: 59332, Effective: 2024-01-01 00:00:00, 45 covered, 0 non-covered
CPT 64561 →
CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Article ID: 59332, Effective: 2024-01-01 00:00:00, 45 covered, 0 non-covered
CPT C1767 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z45.42.

3 policies

3 Medicare

Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence
Policy ID: ART-53359
Billing and Coding: Spinal Cord Stimulators for Chronic Pain
Policy ID: ART-57791
Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence
Policy ID: ART-59332

CPT Codes Commonly Billed with Z45.42

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

8 linkages
  • C1820 CMS LCD: Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence CMS LCD
  • L8680 CMS LCD: Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence CMS LCD
  • A4290 CMS LCD: Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence CMS LCD
  • C1883 CMS LCD: Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence CMS LCD
  • C1767 CMS LCD: Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence CMS LCD
  • C1778 CMS LCD: Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence CMS LCD
  • C1897 CMS LCD: Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence CMS LCD
  • L8678 CMS LCD: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence CMS LCD

Convert Z45.42 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
Z45.42 V5302 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To Z45.42

Other codes in section Z40-Z53 (Encounters for other specific health care).

ICD-10 Z45.42, Billing FAQ

Is ICD-10 code Z45.42 billable? +

Yes, Z45.42 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to Z45.42? +

ICD-10 Z45.42 includes: Encounter for adjustment and management of brain neurostimulator; Encounter for adjustment and management of gastric neurostimulator; Encounter for adjustment and management of peripheral nerve neurostimulator, and 3 more clinical synonyms.

What CPT codes are commonly billed with Z45.42? +

Procedures frequently paired with Z45.42 include: C1820, L8680, A4290, C1883, C1767.

What ICD-9 codes does Z45.42 map to? +

Per CMS GEMs, Z45.42 maps to ICD-9 codes: V5302. Useful for legacy data review and historical claim analysis.

Get the full PayerReady toolkit

Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.

Start free →

Run this code through our claim audit tool

Check NCCI bundling, MUE limits, and modifier logic before submission.

Try the auditor →

Did this page help?

Quick signal so we know what to improve.

Thanks!

If you want a code reference page that doesn't exist yet, email coding@payerready.com.

Sorry to hear that.

Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.

Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team

Faster Approvals

Ready to Cut Your Enrollment Timeline in Half?

Join providers in all 50 states who handed off credentialing to a dedicated specialist. Create your free account in minutes and start enrolling the same day.

All 50 States Covered
No Long-Term Contracts
HIPAA HIPAA Compliant Platform
Dedicated Specialist Included