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Electrical Stimulation Devices (TENS) unit

Initiated: 6/2014
Revised:
Reviewed: 2/15, 1/16, 1/17

 

Transcutaneous electrical nerve stimulators (TENS) units are considered medically necessary durable medical equipment (DME) when used as an adjunct or as an alternative to the use of drugs either in the following situations:

  • An adjunct in the treatment of acute post-operative pain in the first 30 days after surgery.
  • An adjunct in the treatment of certain types of chronic, intractable pain not adequately responsive to other methods of treatment, as appropriate, physical therapy and pharmacotherapy.

When the TENS unit is used for the acute post-operative or chronic intractable pain, ConnectCare considers use of the device medically necessary for a trial period of 1 month. Physician records must document a reevaluation of the member at the end of the trial period, indicating how often it was used, the duration of use and its effectiveness. Continued TENS treatment may be considered medically necessary if the treatment significantly alleviates pain and the physician documents the patient is likely to derive benefit from its continued long term use.

Download Follow up Progress Evaluation Report

ConnectCare

Utilization Management

ConnectCare's Utilization Management Staff is available to address questions and issues related to case management and utilization by using the telephone or fax numbers listed below.

ConnectCare Medical Management
4000 Wellness Drive
Midland, MI 48670
Toll free: 888-646-2429
Local: 989-839-1613
Fax: 989-839-1679
 
Hours of Operation
8:00 a.m. - 12:00 p.m.
1:00 p.m. - 5:00 p.m.
Monday - Friday (Eastern Time)

After normal business hours, inbound communications and information may be relayed via fax, confidential voice mail or electronic mail. All precertification requests and/or communications received after normal business hours are returned on the next business day and communications received after midnight on Monday through Friday are responded to on the same business day.

Certified by NCQA since 2007

NCQA Certified Utilization Management"Achieving Utilization Management Certification from NCQA demonstrates that ConnectCare has the systems, process and personnel in place to conduct utilization management in accordance with the strictest quality standards." -- Margaret E. O'Kane, President, NCQA

NCQA has reviewed and certified ConnectCare's Utilization Management functions only. For complete details on the scope of this review, visit www.ncqa.org.