1. (a) Craniotomy, craniectomy or cranioplasty.

   1. (1) Loss of brain function such as memory and/or ability to speak.
   2. (2) Recurrence, continuation or worsening of the condition that required this operation (no improvement or symptoms made worse).
   3. (3) Stroke (damage to brain resulting in loss of one or more functions).
   4. (4) Loss of senses (blindness, double vision, deafness, smell, numbness, taste).
   5. (5) Weakness, paralysis, loss of coordination.
   6. (6) Cerebrospinal fluid leak with potential for severe headaches.
   7. (7) Meningitis (infection of coverings of brain and spinal cord).
   8. (8) Brain abscess.
   9. (9) Persistent vegetative state (not able to communicate or interact with others).
   10. (10) Hydrocephalus (abnormal fluid buildup causing pressure in the brain).
   11. (11) Seizures (uncontrolled nerve activity).
   12. (12) Need for permanent breathing tube and/or permanent feeding tube.

2. (b) Cranial nerve operations.

   1. (1) Weakness, numbness, impaired muscle function or paralysis.
   2. (2) Recurrence, continuation or worsening of the condition that required this operation (no improvement or symptoms made worse).
   3. (3) Seizures (uncontrolled nerve activity).
   4. (4) New or different pain.
   5. (5) Stroke (damage to brain resulting in loss of one or more functions).
   6. (6) Persistent vegetative state (not able to communicate or interact with others).
   7. (7) Loss of senses (blindness, double vision, deafness, smell, numbness, taste).
   8. (8) Cerebrospinal fluid leak with potential for severe headaches.
   9. (9) Meningitis (infection of coverings of brain and spinal cord).
   10. (10) Need for prolonged nursing care.
   11. (11) Need for permanent breathing tube and/or permanent feeding tube.

3. (c) Spine operation, including laminectomy, decompression, fusion, internal fixation or procedures for nerve root or spinal cord compression; diagnosis; pain; deformity; mechanical instability; injury; removal of tumor, abscess or hematoma (excluding coccygeal operations).

   1. (1) Weakness, pain, numbness or clumsiness.
   2. (2) Impaired muscle function or paralysis.
   3. (3) Incontinence, impotence or impaired bowel function (loss of bowel/bladder control and/or sexual function).
   4. (4) Migration of implants (movement of implanted devices).
   5. (5) Failure of implants (breaking of implanted devices).
   6. (6) Adjacent level degeneration (breakdown of spine above and/or below the level treated).
   7. (7) Cerebrospinal fluid leak with potential for severe headaches.
   8. (8) Meningitis (infection of coverings of brain and spinal cord).
   9. (9) Recurrence, continuation or worsening of the condition that required this operation (no improvement or symptoms made worse).
   10. (10) Unstable spine (abnormal movement between bones and/or soft tissues of the spine).

4. (d) Peripheral nerve operation; nerve grafts, decompression, transposition or tumor removal; neurorrhaphy, neurectomy or neurolysis.

   1. (1) Numbness.
   2. (2) Impaired muscle function.
   3. (3) Recurrence, continuation or worsening of the condition that required this operation (no improvement or symptoms made worse).
   4. (4) Continued, increased or different pain.
   5. (5) Weakness.

5. (e) Transphenoidal hypophysectomy or other pituitary gland operation.

   1. (1) Cerebrospinal fluid leak with potential for severe headaches.
   2. (2) Necessity for hormone replacement.
   3. (3) Recurrence or continuation of the condition that required this operation.
   4. (4) Deformity or perforation of nasal septum (hole in wall between the right and left halves of the nose).
   5. (5) Facial nerve injury resulting in disfigurement (loss of nerve function controlling muscles in face).
   6. (6) Loss of senses (blindness, double vision, deafness, smell, numbness, taste).
   7. (7) Stroke (damage to brain resulting in loss of one or more functions).
   8. (8) Persistent vegetative state (not able to communicate or interact with others).
   9. (9) Headaches.

6. (f) Cerebrospinal fluid shunting procedure or revision.

   1. (1) Shunt obstruction (blockage of shunt/tubing causing it to stop draining adequately).
   2. (2) Malposition or migration of shunt/tubing (improper positioning or later movement of shunt/tubing causing it to stop draining adequately).
   3. (3) Seizures (uncontrolled nerve activity).
   4. (4) Recurrence or continuation of brain dysfunction.
   5. (5) Injury to internal organs of the chest or abdomen.
   6. (6) Brain injury.
   7. (7) Stroke (damage to brain resulting in loss of one or more functions).
   8. (8) Persistent vegetative state (not able to communicate or interact with others).
   9. (9) Loss of senses (blindness, double vision, deafness, smell, numbness, taste).
   10. (10) Cerebrospinal fluid leak with potential for severe headaches.
   11. (11) Meningitis (infection of coverings of brain and spinal cord).
   12. (12) Need for prolonged nursing care.
   13. (13) Need for permanent breathing tube and/or permanent feeding tube.

7. (g) Elevation of depressed skull fracture.

   1. (1) Loss of brain function such as memory and/or ability to speak.
   2. (2) Recurrence, continuation or worsening of the condition that required this operation (no improvement or symptoms made worse).
   3. (3) Loss of senses (blindness, double vision, deafness, smell, numbness, taste).
   4. (4) Weakness, paralysis, loss of coordination.
   5. (5) Cerebrospinal fluid leak with potential for severe headaches.
   6. (6) Meningitis (infection of coverings of brain and spinal cord).
   7. (7) Brain abscess.
   8. (8) Persistent vegetative state (not able to communicate or interact with others).
   9. (9) Seizures (uncontrolled nerve activity).
   10. (10) Need for permanent breathing tube and/or permanent feeding tube.

Source Note:The provisions of this §602.13 adopted to be effective December 26, 2023, 48 TexReg 7985.