T.E.N.S. billing and coding

Published: 2010-08-29 20:26:19
Author: Marty Kotlar | ChiroEco | May 2010

Q: I just started supplying my patients with T.E.N.S. machines. What is the best way to bill and code for this therapy?

A: Let’s begin with a little background on T.E.N.S. therapy. Transcutaneous Electrical Nerve Stimulation therapy, more commonly referred to as T.E.N.S. therapy, uses electrical stimulation to diminish pain.

The electrodes are attached to the surface of the patient’s skin over the peripheral nerve to be stimulated. The T.E.N.S. unit works by decreasing the patient’s perception of pain by inhibiting the transmission of afferent pain nerve impulses and/or by stimulating the release of endorphins.

During the procedure, low-voltage electrical current is delivered through electrodes placed on the skin near the source of pain. T.E.N.S. therapy consists of a small, battery-operated device that can diminish pain by stimulating nerve fibers through the skin.

The electricity from the electrodes stimulates the nerves in an affected area and sends signals to the brain that “scramble” normal pain signals, offering short-term pain relief. While effective in the short-term, long-term effectiveness of T.E.N.S. remains questionable.

Reasonable and necessary

T.E.N.S. must be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the function. T.E.N.S. is typically covered for the treatment of patients with chronic, intractable pain or acute post-operative pain.

When a T.E.N.S. unit is used for acute post-operative pain, the medical necessity is usually limited to 30 days from the day of surgery. Payment for more than one month is determined by individual consideration based upon supportive documentation. Payment for the first two months is typically made as a rental.

A T.E.N.S. unit may be denied as not medically necessary for acute pain (less than three months duration) other than post-operative pain. For chronic pain, the patient record must document the location of the pain, the duration of time the patient has had the pain, and the presumed etiology of the pain. The pain must have been present for at least three months.

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