Article Detail - JD DME
RETIRED - Policy Update - TENS (E0720, E0730) Additional KX Modifier Requirements and CMN Requirement Reinstated for Chronic Low back Pain Diagnosis
Article retired due to content incorporation into the applicable Local Coverage Determination or related Policy Article.
Posted August 15, 2013
In the recent revision of the TENS LCD (effective 06/08/2012), the CMN requirement was removed for claims associated with chronic low back pain (CLBP) diagnoses. The requirement had been removed to simplify the documentation requirements for this group. The removal of the requirement for this subset of claims caused denials at CWF. To resolve these denials the CMN requirement for TENS (E0720, E0730) is reinstated for CLBP effective for claims with dates of service on or after 10/01/2013.
Please note this revision of the LCD also requires use of the KX modifier for HCPCS codes E0720 and E0730 (in addition to code E0731) when any one of the coverage criteria, I-III, in the Coverage Indications, Limitations and/or Medical Necessity section are met.
Additionally, the ASSOCIATED INFORMATION section of the LCD and the NONMEDICAL NECESSITY COVERAGE AND PAYMENT RULES section of the related policy article for TENS has been updated to include face to face encounter requirements as outlined in Section 6407 of the Affordable Care Act.
Refer to the TENS LCD and related Policy Article for additional information.
Last Updated Thu, 10 Jan 2019 12:53:06 +0000