Wiki Trial Stimulator

[NESmith]

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

 

[dwaldman]

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 “as 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 pain� (FDA, 2004).