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Electrical Stimulation (Manual) (CPT code 97032)


This modality includes the following types of electrical stimulation:

- Transcutaneous electrical nerve stimulation which produces analgesia, strengthening, and functional electrical stimulation. The use of electrical stimulation is considered medically necessary to reduce pain and/or edema and achieve muscular contraction during exercise.

- Neuro-muscular stimulation which is used for retraining weak muscles following surgery or injury and is taken to the point of visible muscle contraction.

- Interferential current/medium current units, which use a frequency that allows the current to go deeper. IFC is used to control swelling and pain.

Specific indications for the use of electrical stimulation include:

- the patient has documented dependent peripheral edema with an accompanying reduction in the ability to contract muscles;

- the patient has a documented reduction in the ability to contract muscles or in the strength of the muscle contraction;

- the patient has a condition that requires an educational program for self-stimulation of denervated muscle (educational program should be limited to 5-7 sessions);

- the patient has a condition that requires muscle re-education involving a training program (e.g., functional electrical stimulation);

- the patient has a painful condition that requires analgesia or a muscle spasm that requires reduction prior to an exercise program; or

- the patient is undergoing treatment for disuse atrophy using a specific type of neurostimulator (NMES) which transmits an electrical impulse to the skin over selected muscle groups by way of electrodes. Coverage for this indication is limited to those patients where the nerve supply to the muscle is intact, including brain, spinal cord, and peripheral nerves, and other non-neurological reasons for disuse are causing the atrophy (e.g., post casting or splinting of a limb, and contracture due to soft tissue scarring).

Standard treatment is 3 to 4 sessions a week for one month when used as adjunctive therapy or for muscle retraining. Additional sessions must meet medical necessity requirements.

Electrical stimulation used in the treatment of facial nerve paralysis, commonly known as Bell’s Palsy, is considered investigational and noncovered. Please refer to the ICD-9 Codes that Do Not Support Medical Necessity section.

Electrical nerve stimulation used to treat motor function disorders, such as multiple sclerosis, is considered investigational and, therefore, noncovered.

Electrical stimulation should not be reported for wound care of any sort because wound care does not require constant attendance.

Electrical stimulation is not medically necessary for the treatment of strokes when there is no potential for restoration of function.

See Electrical Stimulation for Indications Other Than Wound Care (G0283) for coverage guidelines for pelvic floor electrical stimulators.
 

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