Rule 23-209-1.41 - Transcutaneous Electrical Nerve Stimulator (TENS)A. Medicaid defines a transcutaneous electrical nerve stimulator (TENS) as a device that utilizes electrical current delivered through electrodes placed on the surface of the skin to decrease the patient's perception of pain by inhibiting the transmission of afferent pain nerve impulses and/or stimulating the release of endorphins.B. Medicaid covers TENS for all beneficiaries when prior authorized by the Utilization Management and Quality Improvement Organization (UM/QIO), the Division of Medicaid or designated entity, for rental up to purchase amount, or purchase when indicated when ordered by a physician and one (1) of the following criteria is met: 1. The TENS unit is being used for acute post-operative pain, the beneficiary is within thirty (30) days post-op, other treatment modalities have failed and the patient is being treated at home rather than an inpatient hospital. Approval is limited to thirty (30) days rental.2. The beneficiary has intractable chronic pain of at least three (3) months duration from date of onset and a history of failed response to other treatment modalities. A thirty (30) to sixty (60) day trial period is required. C. Medicaid covers for a conductive garment to be used with a TENS unit when ordered by the practitioner only if one (1) of the following apply: 1. The beneficiary cannot manage without the conductive garment because there is such a large area or so many sites to be stimulated and the stimulation would have to be delivered so frequently that it is not feasible to use conventional electrodes, adhesive tapes, and lead wires. 2. The beneficiary cannot manage without the conductive garment for the treatment of chronic intractable pain because the areas or sites to be stimulated are inaccessible with the use of conventional electrodes, adhesive tapes, and lead wires.3. The beneficiary has a documented medical condition, such as a skin condition, that precludes the application of conventional electrodes, adhesive tapes, and lead wires.4. The beneficiary requires electrical stimulation beneath a cast to treat chronic intractable pain.D. Medicaid requires for purchase to be considered, the practitioner must provide a copy of the re-evaluation performed at the end of the trial period and documentation that the patient is likely to derive significant therapeutic benefit from continuous use of the unit over a long period of time.E. If a four (4) lead TENS unit is ordered, the practitioner must document why two (2) leads are insufficient to meet the patient's needs.23 Miss. Code. R. 209-1.41
42U.S.C. § 1395m; Miss. Code Ann. §§ 43-13-117(17), 43-13-121.