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   Below is a list of non covered diagnosis, and diagnosis codes,  by Medicare for the rental and purchase of a tens machine ( transcutaneous electrical nerve stimulator) , and the purchase of tens supplies.  MedFaxx is an accrediated provider of tens machines for Medicare patients, FOR NOW.

February 21, 2013

TO:                          PHYSICAL THERAPISTS

FROM:                     MEDFAXX, INC.

SUBJECT: DIAGNOSIS CODES NOT COVERED BY MEDICARE FOR TENS

According to Medicare’s new rulings, coverage will no longer be afforded to cover the cost of a TENS unit rental or purchase or supplies if the patient received the TENS to control pain for any of the following diagnoses:

·         353.4       Lumbosacral root lesions, not elsewhere classified

·         720.2       Sacroiliitis, not elsewhere classified

·         721.3       Lumbosacral spondylosis without myelopathy

·         721.42     Thoracic or lumbar spondylosis with myelopathy – lumbar region

·         722.10     Lumbar intervertebral disc without myelopathy

·         722.52     Lumbosacral intervertebral disc

·         722.73     Intervertebral disc disorder myelopathy – lumbar region

·         722.83     Post laminectomy syndrome – lumbar region

·         722.93     Other and unspecified disc disorders, lumbar region

·         724.02     Spinal stenosis, lumbar region without neurogenic claudication

·         724.03     Spinal stenosis, lumbar region with neurogenic claudication

·         724.2       Lumbago

·         724.3       Sciatica

·         724.4       Thoracic or lumbosacral neuritis or radiculitis, unspecified, radicular syndrome of lower extremities

·         738.4       Acquired spondylolysthesis

·         739.3       Non-allopathetic lesions NEC (not elsewhere classified)-lumbar region

·         756.11     Spondylosysis, lumbosacral region

·         756.12     Spondylolisthesis

·         805.4       Fracture of vertebral column without mention of spinal cord injury,lumbar,closed

·         806.4       Fracture of vertebral column with mention of spinal cord injury, lumbar, closed

·         846.0       Sprains and strains of sacroiliac region – lumbosacral (joint) (ligament)

·         846.1       Sprains and strains of sacroiliac ligament

·         847.2       Sprains and strains of other and unspecified parts of back, lumbar

·         953.2       Injury to nerve roots and spinal plexus, lumbar root

·         339.0       346.9     784.0  Headaches    

·         524.6       TMJ (Temporomandibular pain)

·          625.9      Pelvic Pain

·          789.0      Visceral abdominal pain

If a Medicare patient is issued a tens unit for any of these diagnosis, Medicare will not cover the cost. MedFaxx will make every effort to assist the patient with a discounted out-of-pocket price for the unit and supplies if the patient wishes to keep the unit. If you have any questions, please give us a call at 1-800-937-3993.