Every policy word on this page is CMS's own. Verzi adds pins, receipts, and links only.
Transcutaneous Electrical Joint Stimulation Devices (TEJSD)
LCD L34821 · CMS's HCPCS descriptor for E0731: Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric).
CMS lists E0731 in 2 LCDs in the Verzi KB: LCD L33802 LCD L34821
Not on CMS's Required Prior Authorization List for DMEPOS on 2026-10-13. source
LCD L34821 · 7 versions, 2015 to today · last changed 2020-01-01 (R6)
Version 7 of LCD L34821: in force by CMS's dates 2015-10-01 to 2015-09-30. The policy text on this page comes from this archived version. On its start date, 2015-10-01, the companion Article in force was Article A52713 version 6.
JA · Noridian 16013
JB · CGS 17013
JC · CGS 18003
JD · Noridian 19003
source
CMS's Who are the MACs jurisdiction pages (DME facts as of 2025-09-30) name each contractor and its states; the MCD's Contractor Information table on every DME LCD prints the contract numbers. Both read 2026-10-09. Verzi adds the state lookup only.
Sections in this version: Coverage Indications, Limitations, and/or Medical Necessity · Coding Information · Associated Information · Sources of Information and Basis for Decision. Plus 4 sections marked N/A in this version.
Full verbatim text serves to customers · Customer? Log in
Version history, LCD L34821
CMS numbers each version. Each box shows the version's window by CMS's stated dates. Select a version to show it on this page. Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask. Version numbers CMS never published to its archive do not exist as documents.
Revision history, every version
CMS's own change log, quoted, 6 entries. It does not change with the version shown. A revision (R-number) is a change CMS logged. The version (vN) is the snapshot that carries it.
R6 · 2020-01-01 · v21
Revision Effective Date: 01/01/2020 GENERAL: Revised: Order information as a result of Final Rule 1713 CODING INFORMATION: Removed: Field titled “Bill Type” Removed: Field titled “Revenue Codes” Removed: Field titled “ICD-10 Codes that Support Medical Necessity” Removed: Field titled “ICD-10 Codes that DO NOT Support Medical Necessity” Removed: Field titled “Additional ICD-10 Information” DOCUMENTATION REQUIREMENTS: Revised: “physician’s” to “treating practitioner’s” GENERAL DOCUMENTATION REQUIREMENTS: Revised: “Prescriptions (orders)” to “SWO” 02/27/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.
R5 · 2017-01-01 · v15
Revision Effective Date: 01/01/2017 COVERAGE INDICATIONS, INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY: Removed: Standard Documentation Language Added: New reference language and directions to Standard Documentation Requirements Added: General Requirements DOCUMENTATION REQUIREMENTS: Removed: Standard Documentation Language Added: General Documentation Requirements Added: New reference language and directions to Standard Documentation Requirements POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Removed: Standard Documentation Language Added: Direction to Standard Documentation Requirements Removed: Supplier Manual reference under Miscellaneous Removed: PIM reference under Appendices SOURCES OF INFORMATION AND BASIS FOR DECISION: Removed: Sources of Information RELATED LOCAL COVERAGE DOCUMENTS: Added: LCD-related Standard Documentation Requirements article
R4 · 2016-07-01 · v12
Effective July 1, 2016 oversight for DME MAC LCDs 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 LCDs.
R3 · 2015-10-01 · v9
Revision Effective Date: 10/31/2014 Sources of Information and Basis for Decision: Removed: Non-working Medscape link #10
R2 · 2015-10-01 · v8
Revision Effective Date: 10/31/2014 COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY: Revised: Standard Documentation Language to add covered prior to a beneficiary’s Medicare eligibility Revised: Standard Documentation Language for WOPD to make consistent with ACA requirements DOCUMENTATION REQUIREMENTS: Revised: Standard Documentation Language for WOPD to make consistent with ACA requirements Revised: Standard Documentation Language to add who can enter date of delivery date on the POD Added: Instructions for Equipment Retained from a Prior Payer
R1 · 2015-10-01 · v7
Revision Effective Date: 10/01/2014 Draft LCD promoted to final
Receipts for auditors
Version 7 of LCD L34821, shown on this page: in force by CMS's dates 2015-10-01 to 2015-09-30. Archived 2026-09-26. CMS's copy · Our archived file. 8 of 8 sections are proven word-identical to the archived file.
Every archived version of LCD L34821 (7 versions, CMS's dates, window by the as-of rule).
| Document | Version | In force | Archived on | Verify |
|---|---|---|---|---|
| LCD L34821 | version 2 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| LCD L34821 | version 7 shown | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| LCD L34821 | version 8 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| LCD L34821 | version 9 | 2015-10-01 to 2016-06-30 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L34821 | version 12 | 2016-07-01 to 2016-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L34821 | version 15 | 2017-01-01 to 2019-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L34821 | version 21 | 2020-01-01 to today | 2026-09-26 | CMS's copy · Our archived file |
The related Articles each have their own receipts: Article A55426 · Article A52713.
Each archived file's page gives its sha256 fingerprint. A copy of the file hashes to the same value, byte for byte.
CMS's live page shows only the current version. To check a passage by eye, open CMS's copy of the same version number. A version's window ends on the earlier of CMS's stated end date and the day before the next version starts.
Every policy word on this page is CMS's, from the archived version named beside it. Verzi adds labels, highlights, citations and links only. Verzi-written summary content on this page: none.
Governing policies, as CMS lists them:
- LCD L33802 · Transcutaneous Electrical Nerve Stimulators (TENS)
CMS lists E0731 in group 1 of version 35. CMS's description, quoted: “FORM FITTING CONDUCTIVE GARMENT FOR DELIVERY OF TENS OR NMES (WITH CONDUCTIVE FIBERS SEPARATED FROM THE PATIENT'S SKIN BY LAYERS OF FABRIC)”.
Related Articles, as CMS lists them: Article A55426 · Article A52520 - LCD L34821 · Transcutaneous Electrical Joint Stimulation Devices (TEJSD)
CMS lists E0731 in group 2 of version 21. CMS's description, quoted: “FORM FITTING CONDUCTIVE GARMENT FOR DELIVERY OF TENS OR NMES (WITH CONDUCTIVE FIBERS SEPARATED FROM THE PATIENT'S SKIN BY LAYERS OF FABRIC)”.
Related Articles, as CMS lists them: Article A55426 · Article A52713
From CMS's LCD code table. HCPCS Level II codes only.
source
CMS's LCD code table in the Medicare Coverage Database download, archived 2026-10-09: Our archived file.
Watch E0731
One email when any policy cited for E0731 changes or gains a future effective date. Nothing else, ever.