This is a list of diagnosis that Medicare does not cover for the cost of a tens machine as of July 19, 2013 ( subject to change without notice).
For you to get a tens unit in the United States and have Medicare purchase it, you will need to get a prescription from your doctor (must be an MD, not PA or nurse practitioner) that is not related to back pain. Medicare has changed its policy and will not cover a tens units for several diagnoses. Once we get the doctor’s prescription along with your basic information, we can ship the unit to you. You will then need to re-visit your doctor after 31 days but before sixty days for a re-evaluation and the doctor must complete a Certificate of Medical Necessity and return it to us. Once the unit is purchased by Medicare, at the present time, they will cover two supplies per month. The supplies can be topical pain lotions, skin creams, tens electrodes, tens cables, and those products ( no drugs ) related to relieving your chronic pain. Most of the topicals are Tiger Balm patches & lotions, BioFreeze, hot/cold packs, Flex-all, and Vit. E/Aloe lotions.
Please call (800-937-3993) or This email address is being protected from spambots. You need JavaScript enabled to view it.if we can be of additional service.
The diagnoses that Medicare will not cover are listed below:
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
