# Trial Stimulator



## NESmith (Oct 6, 2011)

We have a patient (Medicare primary) who for chronic pain had a trial stimulator in Feb 2011 with 75% relief, then had the trial stimulator removed in Mar 2011. Patient was instructed to contact a provider to put in a permanent (5yr) stimulator placement but the patient never followed thru on this. Now the patient has return and is requesting another trial stimulator. I am not sure if this can be done and I can not find anything on Medicare's web-site pertaining to this. Please help and as always Thanks


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## dwaldman (Oct 8, 2011)

If the patient feels they need to confirm with another successful trial before deciding on permanent placement, I think the carrier would agree this be worth the cost. I am not sure if your state Medicare carrier has an LCD for SCS procedures. Below it does not mention second trials  in the NCD I also found some additional info that I thought was informative.


http://www.controlyourpain.com/file...e National Coverage Determination for SCS.pdf


http://www.controlyourpain.com/professionals/reimbursement/resources.cfm

When asked at 24 months:
- 66% patients were satisfied with their
pain relief
- 93% patients said they would repeat
the experience
• 19/42 (45%) patients experienced 34 SCS-related
complications.
- 13/42 patients (31%) required a device-related
surgical revision
- Most occurred in the first year and were
benign, reversible, and not incapacitating.

http://www.cigna.com/assets/docs/he...epositioncriteria_spinal_cord_stimulation.pdf

Patients eligible for lumbar or thoracic dorsal column SCS experience pain relief from a temporary trial of SCS and demonstrate a psychological profile that would be consistent with successful dorsal column stimulation.

U.S. Food and Drug Administration (FDA)
SCS devices are approved for use â€œas an aid in the management of chronic intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with the following: failed back surgery syndrome, intractable low back pain and leg painâ€� (FDA, 2004).


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