Glossary

40 TENS, pain and coverage terms in plain English. Every term links to its source.

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Acute pain: Acute pain is pain that starts recently and is expected to last a shorter time. Medicare's TENS policy denies TENS for acute pain other than post-operative pain.

Cardiac pacemaker: A cardiac pacemaker is an implanted device that uses low-energy electrical pulses to control heart rate and rhythm. The NHS and University of Iowa say not to use TENS with one.
Carpal tunnel syndrome: Carpal tunnel syndrome is a group of problems with numbness, tingling, weakness or pain in the wrist or hand, which happens when a nerve in the wrist becomes squeezed.
Chronic low back pain: Chronic low back pain is low back pain that has lasted three months or longer. Medicare's TENS policy denies TENS for it as not reasonable and necessary.
Chronic pain: Chronic pain is pain that lasts a long time. MedlinePlus says it can affect daily life, and Medicare's TENS policy requires pain present for at least three months.
Conductive garment: A conductive garment is clothing with built-in electrodes that can replace electrode pads. Medicare's TENS policy covers one only when specific conditions are met.
Contraindication: A contraindication is a specific situation in which a medicine, procedure or device should not be used because it may be harmful to the person.

DME MAC: A DME MAC is a Medicare Administrative Contractor that processes Medicare durable medical equipment claims for a region. Florida claims go to DME MAC Jurisdiction C.
Durable medical equipment: Durable medical equipment, or DME, is medical equipment made for repeated use at home. Medicare Part B covers medically necessary DME when a doctor or other provider orders it for home use.

Electrode pad: An electrode pad is a sticky patch that sits on the skin and carries the current from the TENS unit lead wires into the body.
Electrotherapy: Electrotherapy is a group of physical therapy methods that aim to reduce pain and improve function by putting energy into the body. Some methods use electrical current.
EMS: EMS, or electrical muscle stimulation, uses electrical current through electrodes to make muscles contract. It is different from TENS, which targets pain.
Endorphins: Endorphins are hormones your brain releases when your body feels pain or stress. The NHS says TENS is thought to work partly by encouraging their release.

Face-to-face encounter: A face-to-face encounter is a practitioner visit that gathers information about the condition for which equipment is ordered. CMS requires one for items on its required list.

Gate control theory: Gate control theory is an explanation that nerve gates decide which pain signals pass through to the brain. It is one idea about how TENS may work.

Implanted medical device: An implanted medical device is a device placed inside or on the surface of the body. University of Iowa says not to use TENS with any implanted metallic or electronic device.
Interferential current therapy: Interferential current therapy is a form of electrotherapy that uses a medium frequency alternating current, delivered through electrodes, and clinicians use it in pain care.

Lead wire: A lead wire is the cable that connects an electrode pad to the TENS unit. Most units use two or four lead wires, and a lead wire can wear out.
Local coverage determination: A local coverage determination, or LCD, is a decision by a Medicare contractor on whether an item is reasonable and necessary in its region. LCD L33802 covers TENS units.
Lumbar spine: The lumbar spine is the lower back section of the spine. Cleveland Clinic says it consists of five vertebrae that support body weight and protect the spinal cord.

Medical necessity: Medical necessity means services or supplies that meet accepted standards of medical practice to diagnose or treat a medical condition, as a payer applies the term.
Medicare Advantage: Medicare Advantage is a private-plan alternative to Original Medicare. Each plan can have its own network and approval rules, so ask your plan about TENS units.
Medicare Part B: Medicare Part B is the part of Original Medicare that helps cover medically necessary outpatient services, preventive services and durable medical equipment ordered for use at home.

NMES: NMES, or neuromuscular electrical stimulation, uses electrical impulses delivered through electrodes on the skin to create muscle contractions, and clinicians may use it in rehabilitation.
Non-opioid pain management: Non-opioid pain management means ways to treat pain that do not use opioid drugs. CDC says nonopioid therapies are preferred for subacute and chronic pain.

Peripheral neuropathy: Peripheral neuropathy is damage to nerves outside the brain and spinal cord. It can cause pain, tingling or numbness, and its causes vary.
Plantar fasciitis: Plantar fasciitis is inflammation of the plantar fascia in the foot. Cleveland Clinic calls it the most common cause of heel pain.
Post-operative pain: Post-operative pain is pain that follows surgery. Medicare's TENS policy covers TENS for it only as a rental, for 30 days from the day of surgery.
Preauthorization: Preauthorization is approval that an insurance plan gives before a device or service is provided. Each plan sets its own rules, so check with your plan.
Pulse frequency: Pulse frequency is how many pulses the TENS unit sends each second. It is an adjustable setting that your clinician and the device instructions guide.
Pulse width: Pulse width, also called pulse duration, is the time each electrical pulse lasts. It is one of the settings a clinician or device instructions may adjust.

Sciatic nerve: The sciatic nerve is the largest nerve in the body. It starts in the lower back and runs down the back of each thigh into the lower leg.
Sciatica: Sciatica is pain from irritation or compression of the sciatic nerve. It can be felt in the lower back and leg, and may include tingling or numbness.
Skin irritation: Skin irritation from electrode pads can show as redness, rash or itching. The NHS says to turn off the unit and remove the pads, and University of Iowa says to tell your care team.
Stimulation intensity: Stimulation intensity is how strong the current feels. A 2022 review calls it critical to therapeutic success, and the NHS says it should not be painful.

TENS: TENS, short for transcutaneous electrical nerve stimulation, sends mild electrical pulses through electrode pads on the skin to relieve pain. FDA classifies the device as Class II.
TENS unit: A TENS unit is a small, battery-powered device with wires and electrode pads that sends mild electrical pulses through the skin to relieve pain, used as your clinician and the device instructions direct.
Text neck: Text neck, also called tech neck, is neck, shoulder and back strain from tilting your head forward to look at a phone or tablet.
Trial period: A TENS trial period is a first stretch of use in which the treating practitioner monitors whether the unit modulates pain. Medicare's policy sets the length for chronic pain.

Written order prior to delivery: A written order prior to delivery, or WOPD, is a complete order that a supplier must hold before it delivers certain items that CMS places on a required list.

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