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Is Transcutaneous Electrical Joint Stimulation Covered by Insurance?

Posted on March 11 2014

Electrical stimulation is used to relieve pain resulting from conditions such as osteoarthritis and rheumatoid arthritis. This method of pain relief is commonly advised in cases where traditional treatments and therapies have failed to provide adequate relief. However, although this treatment has shown some success in clinical trials, in most cases it is still not covered by insurance companies.   What is Transcutaneous Electrical Stimulation?   Transcutaneous electrical stimulation delivers a low-voltage, monophasic electrical field directly to the nerves at the target site. This type of therapy is increasing in popularity and becoming a more common treatment method that is used as an alternative to the use of drugs and invasive surgeries for the treatment of pain and the rehabilitation of injuries. However, according to insurance company policies, transcutaneous electrical joint stimulation has not been effectively proven to reduce edema and pain related to conditions such as osteoarthritis and rheumatoid arthritis.   What is Transcutaneous Electrical Stimulation Covered For?   In most cases, TENS stimulators are covered for the treatment of acute post operative pain, as well as for other specific types of chronic pain. Currently, TENS is defined as medically necessary for certain conditions if alternative therapies, including physical therapy and pharmacotherapy, are not adequate to provoke an effective response.   Why Isn't TENS Covered For Treating Edema and Arthritis?   TENS therapy is currently in the investigational or experimental phases of trials for treating and managing conditions such as arthritis and edema. As clinical trials for the treatment of arthritis can vary due to a variety of external factors and disease states, a more rigorous study that includes double blind, randomized, and placebo controlled trials is necessary to validate its true effectiveness. To date, a number of controlled and uncontrolled trials have been conducted on the use of Transcutaneous Electrical Joint Stimulation that have yet to produce conclusive, repeatable, and unbiased positive outcomes.   Sources: https://www.capbluecross.com/wps/wcm/connect/cf9d20d4-33a4-4ff9-ad7a-beab46f8936e/Electrical+Stimulation+for+the+Treatment+of+Arthritis+6.048+11-26-13.pdf?MOD=AJPERES http://www.aetna.com/cpb/medical/data/1_99/0011.html https://www.healthpartners.com/public/coverage-criteria/transcutaneous-electrical-joint-stimulation-devices/

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