Transcutaneous Electrical Nerve Stimulators (TENS) - Policy Article

Revision Effective Date: 01/01/2023
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Billing information relevant to CMNs, for DOS affected by the CMN elimination


11/17/2022: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision History Effective Date: 11/20/2021
MODIFIERS:
Removed: Q0 (zero) modifier from sub-header


05/26/2022: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision History Effective Date: 11/20/2021
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):
Removed: “The link will be located here once it is available.”
Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list


04/14/2022: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

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evision History Effective Date: 11/20/2021
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Revised: Language regarding supply allowances during the rental period for clarification
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Removed: Medical records statement for Criterion III as coverage expired June 7, 2015 for CLBP under NCD 160.27
MODIFIERS:
Removed: Q0 modifier statements regarding Criterion III as coverage expired June 7, 2015 for CLBP under NCD 160.27
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: ICD-10-CM codes used for CLBP as coverage expired June 7, 2015 for CLBP under NCD 160.27
ICD-10-CM CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Removed: Statement under paragraph 1 regarding CLBP and all codes not specified


10/07/2021: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision History Effective Date: 01/01/2020
 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
 Removed: REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO 42 CFR 410.38(g) section
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
 Added: Section and related information based on Final Rule 1713
 CERTIFICATE OF MEDICAL NECESSITY (CMN):
 Revised: “physician” to “practitioner”
 Revised: “physician” to “treating practitioner”
 Removed: CMN form version number “(DME form 06.03B)”
 Revised: “detailed written order” to “Standard Written Order (SWO)”
 Revised: “detailed written order” to “SWO”
 ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
 Revised: Section header “ICD-10 Codes that are Covered” updated to “ICD-10 Codes that Support Medical Necessity”
 ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
 Revised: Section header “ICD-10 Codes that are Not Covered” updated to “ICD-10 Codes that DO NOT Support Medical Necessity”


02/27/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision History Effective Date: 01/01/2019
ICD-10 CODES THAT ARE COVERED:
 Added: All diagnosis codes formerly listed in the LCD
ICD-10 CODES THAT ARE NOT COVERED:
 Added: Notation excluding all ICD-10 codes not specified above for TENS used for CLBP. TENS for all other uses not specified


02/21/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision Effective Date: 01/01/2017
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Added: 42 CFR 410.38(g)
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Coverage criteria information, CMN and Modifier requirements
RELATED LOCAL COVERAGE DOCUMENTS:
Added: LCD-related Standard Documentation Requirements Language Article

Effective July 1, 2016 oversight for DME MAC Articles is the responsibility of CGS Administrators, LLC 18003 and 17013 and Noridian Healthcare Solutions, LLC 19003 and 16013. No other changes have been made to the Articles.

Revision Effective Date: 10/31/2014
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Removed: “When required by state law” from ACA new prescription requirements
Revised: Face-to-Face Requirements for treating practitioner