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Tuesday, August 14, 2012

CMS Rules Out TENS Units for Low Back Pain

"TENS is not reasonable and necessary for the treatment of CLBP under section 1862(a)(1)(A) of the Social Security Act."

The Centers for Medicare and Medicaid (CMS) has issued a ruling that will impact on the payment of proceeds in Workers' Compensation Medicare Set Aside Agreements (WCMSA). CMS has ruled out the use of TENS (Transcutaneous Electrical Nerve Stimulation) units for the treatment of chronic low back pain.

"For those WC [workers' compensation]cases that were not settled prior to June 8, 2012, and where the  WCMSAs proposal includes funding for TENS for CLBP [chronic low back pain] as part of the WCMSA, CMS  will re-review the cases and remove pricing for TENS for CLBP. (Regional Offices shall  obtain from submitters requests for a case re-review, along with a signed statement  indicating a settlement had not occurred prior to June 8, 2012.)"

Case law throughout the country has been divided on whether TENS units should be authorized to cure and relieve low back pain. 

Click here to read: Decision Memo for Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain (CAG-00429N)

Click here to read: Impact of the Removal of coverage of Transcutaneous Electrical Nerve 
Stimulation (TENS) Units for Chronic Low Back Pain (CLBP) on Workers’ Compensation Medicare Set-Aide Arrangement (WCMSA) proposals – INFORMATION

For over 3 decades the Law Offices of Jon L. Gelman  1.973.696.7900 have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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