{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:28:54Z","timestamp":1791322134068,"version":"4.3.1"},"reference-count":19,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:00:00Z","timestamp":1725494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:00:00Z","timestamp":1725494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Stereotact Funct Neurosurg"],"abstract":"<jats:p>Background: The National Coverage Determination (NCD) by the Centers for Medicare and Medicaid Services (CMS) for deep brain stimulation requires that a patient have \u201cadvanced idiopathic Parkinson\u2019s disease (PD) as determined by Hoehn and Yahr (HY) stage or the Unified Parkinson\u2019s Disease Rating Scale part III motor subscale (UPDRS III).\u201d How to apply the HY or UPDRS III scales to define \u201cadvanced\u201d PD is unclear. Summary: There is an ongoing recovery audit by the CMS of deep brain stimulation cases that were covered by Medicare but are deemed not to have met the NCD requirements and therefore not to have been medically necessary. Whether a hospital is asked to refund Medicare often hinges upon whether medical documentation supports the diagnosis of advanced PD. However, neither the HY nor the UPDRS III scales use \u201cadvanced\u201d to define or describe stages of PD. The NCD has an accompanying National Coverage Analysis that reviews the studies that inform the NCD. These studies use \u201cadvanced\u201d as well as the HY and UPDRS III scales. This review identifies how the HY and UPDRS III scales were used to categorize advanced PD in the studies that were cited in the National Coverage Analysis. Key Messages: In the studies used for the NCD for deep brain stimulation for PD, an HY score \u22653 or a UPDRS III score \u226530 was used to describe patient cohorts considered to have advanced PD. <\/jats:p>","DOI":"10.1159\/000540873","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T12:21:19Z","timestamp":1725538879000},"page":"414-419","source":"Crossref","is-referenced-by-count":2,"title":["What Is \u201cAdvanced\u201d Parkinson\u2019s Disease? Defining What Determines Medicare Coverage for Deep Brain Stimulation in the USA"],"prefix":"10.1159","volume":"102","author":[{"given":"Francisco A.","family":"Ponce","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly A.","family":"Shill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2024,9,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.17.5.427"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20213"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1998.89.5.0713"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/121.3.451"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.51.3.850"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199912000-00024"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.53.1.85"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/s0188-4409(00)00077-1"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.55.12.1921"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.57.4.461"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.57.7.983"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/s0090-3019(01)00533-x"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa000827"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.70.4.464"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s100720170050"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s100720170060"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.56.4.548"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1205158"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.929"}],"container-title":["Stereotactic and Functional Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/sfn\/article-pdf\/102\/6\/414\/4308470\/000540873.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/sfn\/article-pdf\/102\/6\/414\/4308470\/000540873.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:35:40Z","timestamp":1745422540000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000540873"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,5]]},"references-count":19,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,12,3]]},"published-print":{"date-parts":[[2024,12,4]]}},"URL":"https:\/\/doi.org\/10.1159\/000540873","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"26868466","asserted-by":"subject"}]},"ISSN":["1011-6125","1423-0372"],"issn-type":[{"value":"1011-6125","type":"print"},{"value":"1423-0372","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,5]]}}}