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Transcutaneous Electrical Nerve Stimulators (TENS)



Document Type Description
CMS 848 CMN [PDF] TENS Certificate of Medical Necessity (CMN)
Physician Letter [PDF] Suppliers may use this letter written by DME Medical Directors to assist in obtaining documentation from physicians
Documentation Checklist [PDF] Suppliers may use this checklist to ensure all of required documentation is gathered



Reference Title Description
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
MLN Matters 7836 Revised Effective for claims with dates of service on or after June 8, 2012, CMS believes the evidence is inadequate to support coverage of TENS for CLBP as reasonable and necessary. Thus, effective for claims with dates of service on and after June 8, 2012, 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 the 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, June 8, 2015.



Review Type Description
Medical Review View notifications and findings of pre and post claim reviews completed by Noridian Medical Review Staff



Topic Reminder

Non-covered item or service

The Food and Drug Administration (FDA) has several product classifications for Transcutaneous Electrical Nerve Stimulators (TENS) devices, one of which is designated for TENS devices that may be sold over-the-counter (OTC).

OTC TENS are identified with FDA product code NUH. OTC TENS are not considered durable medical equipment (DME). OTC TENS must be coded using HCPCS code: A9270 - Non-covered item or service

KG Modifier This modifier must be billed with all TENS supplies (A4595 and A4557) for dates of service on/after January 1, 2018. This does not apply to supplies used with Neuromuscular Electrical Stimulation (NMES).


Last Updated Jan 10, 2018