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Neurology & Pain Management Coding Alert

Pain Management:

Your 4-Step Guide to Submitting Successful TENS Claims, Despite CMS Snub

Published on Thu Jul 19, 2012

CMS stops TENS pay for most low back pain cases, but other payers might allow.Just because CMS announced in June that it will no longer cover transcutaneous electrical nerve stimulation (TENS) for chronic low back pain doesn't mean you should give up all hope. Other payers might reimburse providers for the use of TENs for chronic low back pain, however, so keep these tips in mind when faced with those claims. Get Clear on What Constitutes Chronic Low Back PainMedicare has defined chronic low back pain (CLBP) as: An episode of low back pain that has persisted for three months or longer; and Is not a manifestation of a clearly defined and generally recognizable primary disease entityIn the June 8, 2012 memo, Medicare explained what distinguishes "primary disease manifestation." According to the memo, "For example, there are cancers that, through metastatic spread to the spine or pelvis, may elicit pain [...]
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