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Do not select the HCPCS/CPT code based on the reimbursement amount associated with a particular HCPCS/CPT. Rather select the HCPCS/CPT based on the code that most accurately describes the service actually provided and/or the intention of the treatment to achieve the desired outcome/goal.
In order for a beneficiary’s equipment to be eligible for reimbursement the reasonable and necessary (R&N) requirements set out in the related Local Coverage Determination must be met. In addition, there are specific statutory payment policy requirements, discussed below, that also must be met.
When you code for transcutaneous electrical nerve stimulation (TENS), you'll likely be using one of three codes--64550, 97014 or 97032--but knowing when to use them is the key to unlocking reimbursement.
21 cze 2010 · My practice wants to have non-clinical personnel train patients on how to use TENS units and bill 64550 to the patients insurance. I am of the opinion that this code (or any CPT code) can only be performed by a physician or non-physician practitioner such as a PA, NP, or PT.
22 sty 2019 · The W0420 code replaces code 64550 (Application of surface neurostimulator), which was deleted from the Current Procedural Terminology (CPT®) codebook for 2019. When a provider bills a W0420 code, WSI requires written documentation regarding instruction on the TENS unit to accompany the bill.
Coding and Payment Guide for Medicare Reimbursement: The following are the 2021 Medicare coding and national physician payment rates for spinal cord stimulation procedures. CPT
(TENS) units (CPT Code 64550; HCPCS Codes E0720, E0730. Please refer to the applicable benefit plan ) document. If not specifically limited by the benefit plan, Cigna covers a transcutaneous electrical nerve stimulator (TENS) as medically necessary as an adjunct to conventional postoperative pain - management within 30 days of surgery.
