Transcutaneous Electrical Nerve Stimulators (TENS) - JA DME
Transcutaneous Electrical Nerve Stimulators (TENS)
Coverage
- Transcutaneous Electrical Nerve Stimulators (TENS) Local Coverage Determination (LCD) and Policy Article [PDF]
- TENS for Acute Post-Operative Pain (10.2) National Coverage Determination (NCD)
- TENS for Chronic Low Back Pain (CLBP) (160.27) NCD
- Supplies Used in the Delivery of TENS and Neuromuscular Electrical Stimulation (NMES) (160.13) NCD
- TENS (280.13) NCD
Documentation
- Clinician Letter - Medical Records [PDF] - Letter may be sent to clinicians to help obtain documentation
- CMS 848 CMN - TENS Certificate of Medical Necessity (CMN)
- TENS Documentation Checklist [PDF] - Checklist to ensure suppliers gather all required documentation
Reviews/Audits
- Medical Review - View notifications/findings of pre/post claim reviews completed by Noridian Medical Review
Tips
Topic | Details |
---|---|
A9270 - Non-covered item or service |
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KG Modifier |
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Resources
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 20
- CMS IOM, Publication 100-08, Medicare Program Integrity Manual, Chapter 5
- CMS Medicare Learning Network (MLN) Matters (MM)7836 - Effective for claims with dates of service on/after 06/08/12, CMS believes evidence is inadequate to support coverage of TENS for CLBP as reasonable and necessary. Thus, effective for claims with dates of service on/after 06/08/12, Medicare will only allow coverage of TENS for CLBP defined for this decision as pain for 3 months or longer and not a manifestation of a clearly defined and generally recognizable primary disease entity, when patient is enrolled in an approved clinical study under coverage with evidence development (CED). Note: CED coverage expires three years from the effective date of this CR, 06/08/15
Last Updated Mon, 04 Jan 2021 14:16:18 +0000