About this policy
CMS National Coverage Determination | ncd_id=22 | manual_section=160.2 | coverage_level_code=3 | national_coverage_type=True | under_review=True | lab_ncd=False
Coverage indications
Where electric nerve stimulation is employed to treat motor function disorders, no reimbursement may be made for the stimulator or for the services related to its implantation since this treatment cannot be considered reasonable and necessary. NOTE: For Medicare coverage of deep brain stimulation for essential tremor and Parkinson's disease, see § 160.24 of the NCD Manual.
Documentation requirements
Item/Service Description: While electric nerve stimulation has been employed to control chronic intractable pain for some time, its use in the treatment of motor function disorders, such as multiple sclerosis, is a recent innovation, and the medical effectiveness of such therapy has not been verified by scientifically controlled studies. Cross Reference: Also see NCD on Electrical Nerve Stimulators (§ 160.7 ). Revision History: 02/2003 - Noted that Medicare coverage for deep brain stimulation for essential tremor and Parkenson's disease can be found at §160.24 of the NCD Manual. Effective and implementation dates 04/01/2003. ( TN 167 ) (CR 2553) 03/1997 - Reflected that instruction related to electrical nerve stimulation does not apply to deep brain stimulation provided by an implanted stimulator device and is subject to Medicare coverage at carrier's discretion. Effective date 04/15/1997. (TN 93) Benefit Categories: 52 - Physicians' Services Transmittal: transmittal_number=167 | transmittal_issue_date=2003-02-14 | change_request_number=2553
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.