tci Part B Insider - 2003 Issue 5

MEDICAL DEVICES: Medicare Won't Cover New E-Stim Code

The Centers for Medicare & Medicaid Services has established a HCPCS code for electromagnetic stimulation, but Medicare won't cover the procedure, according to Feb. 28 program memorandum A-03-015. Starting April 1, carriers will automatically deny claim lines for the new code, E0761. CMS told carriers last summer to make their own determinations about covering E-Stim. Meanwhile, CMS issued a new program memo, AB-03-028, clarifying that the program won't cover sacral nerve stimulation for bill types 22X and 23X. As before, the program will cover the therapy for bill types 13X, 14X, 71X, 73X, 75X and 85X in the case...

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