heatherwinters
Expert
I have been asked to research the billable codes for TENS unit trials. Our PT department is going to perform a TENS unit trial on a patient that was ordered by primary. When I researched it I came up with the following information.
Can anyone offer any additional information that would be helpful?
LMRP Database ID Number: L4085
LIMITATIONS
[FONT="]TENS therapy per se is considered to be a self-administered treatment and is not reimbursable as an ongoing service by the physician or physical therapist. The service paid for under CPT code 64550 involves evaluating the effectiveness of the device and educating the patient as to its proper use. However, "... it is inappropriate for a patient to visit his/her physician, physical therapist, or an outpatient clinic on a continuing basis for treatment of pain with electrical nerve stimulation. 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 the patient will employ the TENS on a continual basis in his/her home. Electrical nerve stimulation treatments furnished by a physician in his/her office, by a physical therapist or outpatient clinic are excluded from coverage by § 1862(a)(1) of the Act" (CIM §35-46).
As well as information from
[/FONT][FONT="]160.7.1 - Assessing Patients Suitability for Electrical Nerve Stimulation Therapy
[/FONT]
Can anyone offer any additional information that would be helpful?
LMRP Database ID Number: L4085
LIMITATIONS
[FONT="]TENS therapy per se is considered to be a self-administered treatment and is not reimbursable as an ongoing service by the physician or physical therapist. The service paid for under CPT code 64550 involves evaluating the effectiveness of the device and educating the patient as to its proper use. However, "... it is inappropriate for a patient to visit his/her physician, physical therapist, or an outpatient clinic on a continuing basis for treatment of pain with electrical nerve stimulation. 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 the patient will employ the TENS on a continual basis in his/her home. Electrical nerve stimulation treatments furnished by a physician in his/her office, by a physical therapist or outpatient clinic are excluded from coverage by § 1862(a)(1) of the Act" (CIM §35-46).
As well as information from
[/FONT][FONT="]160.7.1 - Assessing Patients Suitability for Electrical Nerve Stimulation Therapy
[/FONT]