Transcutaneous Electrical Nerve Stimulators (TENS) - JA DME
Transcutaneous Electrical Nerve Stimulators (TENS)
The Standard Written Order (SWO) requirements are in effect for dates of service January 1, 2020 and after.
Refer to the SWO page for the elements needed in this streamlined order.
Coverage
- TENS (280.13) National Coverage Determination (NCD)
- TENS for Acute Post-Operative Pain (10.2) 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
- Transcutaneous Electrical Nerve Stimulators (TENS) Local Coverage Determination (LCD)
- Transcutaneous Electrical Nerve Stimulators (TENS) Policy Article
Documentation
- Standard Documentation Requirements for All Claims Submitted to DME MACs
- Clinician Checklist Transcutaneous Electrical Nerve Stimulators (TENS) [PDF] - Checklist to assist clinicians with coverage and documentation requirements
- Clinician Checklist Transcutaneous Electrical Nerve Stimulators (TENS) Conductive Garment [PDF] - Checklist to assist clinicians with coverage and documentation requirements
- Clinician Letter - Medical Records [PDF] - Letter may be sent to clinicians to assist in obtaining 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 |
|---|---|
| KG Modifier |
|
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 Change Request (CR)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, 17 Jan 2022 14:35:00 +0000