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Official Description

Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation
Short Descr Tens two lead
Coverage Special coverage instructions apply
Pricing Indicator(s) 32 – Supplies And Surgical Dressings - Inexpensive & routinely purchased DME (price subject to floors and ceilings)
MPI A – Not applicable, as HCPCS priced under one methodology
CIM 35-20
MCM 4107.6
BETOS D1E – Other DME
TOS Code(s) A – Used durable medical equipment (DME)
Added Date 1/1/1986
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 0
MUE 1
IOM 100-03, 2, 160.2
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
KX Requirements specified in the medical policy have been met
RR Rental (use the 'rr' modifier when dme is to be rented)
NU New equipment
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CG Policy criteria applied
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
GP Services delivered under an outpatient physical therapy plan of care
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
KV Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service
Date
Action
Notes
1986-01-01 Added Code added 1/1/1986
Code
Description
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