An NCD sets forth the extent to which Medicare will cover specific services, procedures, or technologies on a national basis.
Medicare coverage is limited to items and services that are considered "reasonable and necessary" for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category). NCDs are made through an evidence-based process, with opportunities for public participation. NCDs are developed and published by CMS and apply to all states. Medicare Administrative Contractors may find it helpful to work with Quality Improvement Organizations to obtain the information needed to apply these conditions to claims. Demonstration of pain relief with a temporarily implanted electrode precedes permanent implantation.
#Nerve stimulator professional
All the facilities, equipment, and professional and support personnel required for the proper diagnosis, treatment training, and follow up of the patient (including that required to satisfy item c) must be available and.(Such screening must include psychological, as well as physical evaluation) Patients have undergone careful screening, evaluation and diagnosis by a multidisciplinary team prior to implantation.With respect to item a, other treatment modalities (pharmacological, surgical, physical, or psychological therapies) have been tried and did not prove satisfactory, or are judged to be unsuitable or contraindicated for the given patient.The implantation of the stimulator is used only as a late resort (if not a last resort) for patients with chronic intractable pain.No payment may be made for the implantation of dorsal column or depth brain stimulators or services and supplies related to such implantation, unless all of the conditions listed below have been met: Depth Brain Neurostimulation - The stereotactic implantation of electrodes in the deep brain (e.g., thalamus and periaqueductal gray matter) is covered.Dorsal Column (Spinal Cord) Neurostimulation - The surgical implantation of neurostimulator electrodes within the dura mater (endodural) or the percutaneous insertion of electrodes in the epidural space is covered.There are two types of implantations covered by this instruction: The implantation of central nervous system stimulators may be covered as therapies for the relief of chronic intractable pain, subject to the following conditions: Central Nervous System Stimulators (Dorsal Column and Depth Brain Stimulators) As explained in §160.7.1, such use of the stimulator is covered as part of the total diagnostic service furnished to the beneficiary rather than as a prosthesis.ī. NOTE: Peripheral nerve stimulators may also be employed to assess a patient’s suitability for continued treatment with an electric nerve stimulator. Implantation of electrodes requires surgery and usually necessitates an operating room.
#Nerve stimulator generator
Stimulation is induced by a generator connected to an antenna unit which is attached to the skin surface over the receiver unit. The stimulating electrode is connected by an insulated lead to a receiver unit which is implanted under the skin at a depth not greater than 1/2 inch. Use of this stimulator involves implantation of electrodes around a selected peripheral nerve.
Payment may be made under the prosthetic device benefit for implanted peripheral nerve stimulators.
Two general classifications of electrical nerve stimulators are employed to treat chronic intractable pain: peripheral nerve stimulators and central nervous system stimulators.Ī.
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