Peripheral Nerve Stimulation (L37360) - R5 - Effective December 1, 2019

Date Posted: September 25, 2025

This Local Coverage Determination (LCD) has been revised under contractor numbers: 02101 (AK), 02201 (ID), 02301 (OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).

Effective Date: Effective December 1, 2019

Summary of Changes:

Under Coverage Indications, Limitations, and/or Medical Necessity, corrected the typographical error in Paragraph 1 from 'interdenominational' to 'interventional'.

At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination.

Visit the Noridian Active LCDs webpage to view the Active LCD or access it via the CMS MCD.

Last Updated Sep 25 , 2025