RNS System is associated with lower 30 Day readmission rates in DRG 026

In Epilepsy

By: Raj Kumar  May. 08, 2019

RNS system (Neurostimulator system)’s ICD 10 Procedure code 00H00MZ used by Hospitals to get additional payment under NTAP program from CMS. NTAP(New Technology Add-on payment) payment is an additional payment over and above the DRG allowed payment amount.

According to Neuropace, the manufacturer of the RNS System- “The RNS® System of Neuropace is an adjunctive therapy in reducing the frequency of seizures in individuals 18 years of age or older with partial onset seizures who have undergone diagnostic testing that localized no more than 2 epileptogenic foci, are refractory to two or more antiepileptic medications, and currently have frequent and disabling seizures (motor partial seizures, complex partial seizures and/or secondarily generalized seizures). “

The long term treatment study of RNS system showed positive results for patients with drug-resistant epilepsy. A clinical study of 9-year follow-up data showed, 75% response rate, with the 50% patients experienced a decrement in seizures. Additionally, the study has come up with 90% of decrement in seizures, for the 33% patients.

RNS neurostimulation proves to be a safe and effective treatment over time for individuals living with medically refractory epilepsy. The study concludes that patients not only experienced a significant seizure reduction, but improved quality of life and cognitive benefits.

Dexur’s Medicare claims data from Jan 2017 to Dec 2017 shows, the all cause readmission rate at DRG 026 (Craniotomy & Endovascular intracranial procedures w CC) is 31.2% whereas the readmission rate for RNS System when used with the DRG 026 is 22.41%.

Diagnosis Related Groups (DRGs) is a classification system which assigns a hospital stay to one of approximately 750 DRG codes. Dexur has in depth database of patients who have seizures & Epilepsy and can benefit from RNS System Implantation.


Dexur Pro members get detailed quality outcomes for a combination of Kcentra usage and that DRG. Quality outcomes include LOS, Mortality, Readmission and SNF Discharge rates.


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Raj Kumar

Rajkumar is a business analyst with experience in Real World Evidence studies (RWE), healthcare claim analytics, literature review, data analytics, End to End medical billing and revenue cycle management solutions in physician services. Received bachelor's degree in Life sciences.