Condition
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.
CMS defines chronic low back pain for its TENS decision as an episode of low back pain that has persisted for three months or longer. CMS said it would cover TENS for it only for patients in an approved clinical study, for dates of service on or after June 8, 2012. Today, the Medicare TENS policy, as of the revision effective January 1, 2024, says TENS therapy for chronic low back pain will be denied as not reasonable and necessary. Other plans may use different rules, so check with yours. Talk with your clinician about other options. Read TENS for lower back pain and see lumbar spine.
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