Eli's Rehab Report

Question: How should we code for using the TENS unit? I read once that this is coded with the 60000 series for the first use, then coded differently when the patient returns for additional treatments.

Pennsylvania Subscriber

Answer: TENS (transcutaneous electrical nerve stimulators) units often are used to anesthetize a patient's nerve to control or block pain. Application of the TENS neurostimulator is coded using 64550 (Application of surface [transcutaneous] neurostimulator). This code is also appropriate for billing subsequent treatments. What you are referring to is probably the reference in CPT, "for initial or subsequent electronic analysis and programming of neurostimulator pulse generators, see codes 95970-95975." This applies to implanted neurostimulators, which must be reprogrammed and analyzed periodically. This does not refer to TENS units, which are not implantable.

A TENS unit must be distinguished from other electrical stimulators such as neuromuscular stimulators, which are used to directly stimulate muscles and/or motor nerves and are coded as 97032 (Application of a modality to one or more areas; electrical stimulation [manual], each 15 minutes).

Most carriers require that TENS treatments for chronic pain be used only after the patient has had the pain for at least three months, and that other treatment modalities have been attempted and have not worked. The patient's record should include documentation of the onset of the pain and what other treatments have been tried.