TRANSCUTANEOUS ELECTRICAL NERVE STIMULATOR (TENS) AND SUPPLIES |
C |
if used for the treatment of chronic, intractable pain subject to the following:
- the pain must have been present for at least three months, and
- the presumed etiology of pain must be a type which is accepted as responding to TENS therapy (e.g. headache, visceral abdominal pain, pelvic pain, or TMJ pain)
if used for the treatment of acute post-operative pain subject to the following:
- the medical necessity is less than 90 days from surgery date
- limited to a two month trial period (after one month, extra documentation is necessary) after which the purchase may be covered under the Prosthetic Devices benefit.
Replacement Supplies covered when medically necessary and used with a purchased TENS Unit. A PHYSICIAN'S PRESCRIPTION MUST BE FURNISHED TO THE SUPPLIER PRIOR TO DELIVERY.
==> Prior authorization is available. |