Frequently Asked Questions
Medicare has a positive National Coverage Determination (NCD) for Electrical Nerve Stimulators, NCD# 100-3., in which Implanted Peripheral Nerve Stimulation is part of PNS NCD.
However, Noridian, a Medicare Administrative Contractor, has a separate positive policy, Local Coverage implanted Decision (LCD), for Peripheral Nerve Stimulators, LCD #L37360 PNS LCD.Noridian covers the following states:
California, Hawaii, Nevada, American Samoa, Guam, Northern Mariana Islands, Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming.
If you have any questions on these policies, please call the Reimbursement Support Team at 561-406-8283.
Micron will use reasonable efforts to provide accurate information herein, but this information should not be construed as providing clinical advice, dictating reimbursement policy, or as a substitute for the judgment of a healthcare provider. It is always the healthcare provider’s responsibility to determine the appropriate codes, charges for services, and use of modifiers for services rendered and to complete and submit coverage or reimbursement-related documentation. Providers should always check with the appropriate payer before submitting claims. Providers are responsible for verifying coverage with payers, including the applicability of any non-coverage policies that may exist. Micron assumes no responsibility for the timeliness, accuracy, or completeness of the information provided. Reimbursement laws, regulations, and payer policies change frequently without notice. It is highly recommended that providers consult with their payers, coding specialists, and/or legal counsel regarding coverage, coding, and payment issues.