BCBS of Illinois denying TENS based on published evidence

[Doctodd]

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Just received a denial for a patient i see in Florida who has BCBS of Illinois. They state a TENS unit was not covered due to it being "considered investigational, experimental, and unproven" based on published evidence. Anybody have a rebuttal to this?

 

[PMR 4 MSK]

BCBS decided last year to go after TENS and routinely denies it here (Illinois). I let the RS Medical rep write the appeal letter/ LOMN. If they got it through EMPI, they are on their own, their reps will not write the letters.

 

[lobelsteve]

AAN just put out their bought statement saying TENS doesn't work. EMPI is actively working on their rebuttal from industry.

Again, the AAN must have been paid to come up with such a biased guideline. I read it and noticed it looked markedly incomplete.

 

[mille125]

Just received a denial for a patient i see in Florida who has BCBS of Illinois. They state a TENS unit was not covered due to it being "considered investigational, experimental, and unproven" based on published evidence. Anybody have a rebuttal to this?

BCBS of Texas has never paid for TENS at anytime during my tenure here. It is funny because they are the only one. Medicare and medicaid pay for it.