(TN 48) (CR4278). Please enable "JavaScript" and revisit this page or proceed with browsing CMS.gov with This diagnostic procedure which involves stimulation of peripheral nerves by a needle electrode inserted through the skin is performed only in a physician's office, clinic, or hospital outpatient department.

Generally, the physician or physical therapist is able to determine whether the patient is likely to derive a significant therapeutic benefit from continuous use of a transcutaneous stimulator within a trial period of 1 month; in a few cases this determination may take longer to make. endobj endobj 1 0 obj B. Percutaneous Electrical Nerve Stimulation (PENS). 704 0 obj <>stream Once it is determined that electrical nerve stimulation should be continued as therapy and the patient has been trained to use the stimulator, it is expected that a stimulator will be implanted or the patient will employ the TENS on a continual basis in his/her home. If TENS significantly alleviates pain, it may be considered as primary treatment; if it produces no relief or greater discomfort than the original pain electrical nerve stimulation therapy is ruled out. In a few cases, this determination may take longer to make. Note: Percutaneous Electronic Nerve Stimulator (PENS), when covered, are a DME benefit and are subject to any applicable DME co-insurance and benefit maximum CPT Codes There is no specific CPT code for this service. Also, you can decide how often you want to get updates. Codes • 64561 —Percutaneous implantation of neurostimulator electrodes; sacral nerve (transforamenal placement) Note: Modifier (-59 or -51 may apply if multiple leads are placed) Device Codes: • C1897 —Lead, neurostimulator test kit (implantable), OR • … Effective date NA. 3 0 obj A patient can be taught how to employ the stimulator, and once this is done, can use it safely and effectively without direct physician supervision. h�b```f``Z�����u�A��b�, ���[W��dY�gF��c�k���%�9�f�5u��s�*�h6�г��=����iݴߒi�Ϧ���9��5�bR?܂�)��Qּ�,�s���\F�,� �-��恹@Z�������� K���2��@Z�%�"!�L�p�<0�@[ß�t&��/��j;��bc����g|�l�3v��,�w�� iF`0^Ҋ�ʓ�404e.�E��9 ��Q � X�d� See §160.27 for an explanation of coverage of the therapeutic use of TENS under the durable medical equipment benefit. As in the case of TENS (described in subsection A), generally the physician should be able to determine whether the patient is likely to derive a significant therapeutic benefit from continuing use of an implanted nerve stimulator within a trial period of 1 month. 0 Other Policies and Guidelines may apply . Usually, the physician or physical therapist providing the services will furnish the equipment necessary for assessment. 657 0 obj <> endobj �] �C�_�ȆRY�5��;�s}C���@�Hw

The CMS.gov Web site currently does not fully support browsers with h�bbd```b``N�������"������f����H��`�P0�̞f7��} ҕ��DrG��W���@�1��.O��۶20+�D������P� stream Expedited Process to Remove National Coverage Determinations, Potential National Coverage Determination (NCD) Topics, Contacts for Part A - Medicare Administrative Contractor (MAC - Part A), Contacts for Part A & B - Medicare Administrative Contractor (A & B MAC), Contacts for Part A & B & Home Health & Hospice- Medicare Administrative Contractor (A & B & HHH MAC), Contacts for Part B - Medicare Administrative Contractor (MAC - Part B), Contacts for Durable Medical Equipment Medicare Administrative Contractor (DME MAC). The medical necessity for such diagnostic services which are furnished beyond the first month must be documented. Effective date 08/07/1995. Therefore, it is covered only when performed by a physician or incident to physician's service. This procedure is done with the patient under local anesthesia, using a test needle to identify the appropriate sacral nerve(s). (See §160.7 for an explanation of coverage of the therapeutic use of implanted peripheral nerve stimulators under the prosthetic devices benefit.) PNE testing is done under local anesthesia. endobj �u��E���ڵIP��t� �e�P��Ea�2R!��JGWF�|?���U�.�^���pg�3��W#H�蕎c�����:,2a�tX��|1GQ�)M��(��IV@u�9���67�9�M�2�';}��-G��Ӏ~&���AB-�[�~�l֖�S f0v�g�o{����w��Z������X�u�����WW oRv ���� x{б�m�1 Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. Accordingly, program payment may be made for the following techniques when used to determine the potential therapeutic usefulness of an electrical nerve stimulator: Document the medical necessity for such services which are furnished beyond the first month. Answer:It is appropriate to report code 64450, Injection, anesthetic agent; other peripheral nerve or branch, for the genicular nerve block of three branches of this nerve around the knee joint; however, code 64450 is reported just once during a session when performing the injection(s). Once identified, a temporary wire lead is inserted through the test needle and left in place for 4 to 7 days.

Effective date: 06/19/2006. 4 0 obj However, the combined program payment which is made for the physician's or physical therapist's services and the rental of the stimulator from a supplier should not exceed the amount which would be payable for the total service, including the stimulator, furnished by the physician or physical therapist alone. 7500 Security Boulevard, Baltimore, MD 21244, Incident to a physician's professional Service, Outpatient Hospital Services Incident to a Physician's Service, National Coverage Determination (NCD) for Assessing Patient's Suitability for Electrical Nerve Stimulation Therapy (160.7.1). CPT Code Description 63650 Percutaneous implantation of neurostimulator electrode array, epidural 63655 Laminectomy for implantation of neurostimulator electrode s, plate/paddle, epidural 63661 Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed 63662 Removal of spinal neurostimulator electrode …

endstream endobj startxref A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services.

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