Spinal cord stimulators are devices implanted into the hip or lower back that contain wires attached to the spinal cord. These wires deliver continuous low-voltage electrical currents, interrupting pain signals to the brain. While this procedure can be an effective treatment for patients, having all the proper documentation is essential.

While not all Medicare Administrative Contractors (MACs) have a local coverage determination (LCD), they all refer back to the national coverage determination (NCD) for their medical reviews. The conditions for coverage under NCD 160.7 are below:

1. The implantation of a stimulator is used as a late resort (if not a last resort) in patients with chronic intractable pain.

2. Other treatment modalities such as pharmacological, surgical, physical, or psychological therapies have been tried; however, they were not satisfactory or were determined to be unsuitable or contraindicated for the patient.

3. Before implantation, a multidisciplinary team was utilized to determine candidacy for stimulation and must include a psychological and physical evaluation.

4. The patient received pain relief from trial/temporary implanted electrodes before permanent implantation.

       a. A successful trial should be associated with a 50% reduction
           in targeted pain or a 50% reduction of analgesic
           medications and show some functional improvement.

5. All facilities, equipment, and professional and support personnel required for the proper diagnosis, treatment training, and patient follow-up must be available.