Does G0282 require prior authorization?

Yes, G0282 requires prior authorization (high confidence). Code explicitly requires prior authorization.

What is the Medicare reimbursement rate for G0282?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

Verity

`G0282`, Electrical stimulation, (unattended), to one or more areas, for wound care

HCPCS/CPT

Prior Authorization

Prior Auth Required

Code explicitly requires prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

Medical records must be maintained and available upon request; every page must be legible and include patient identification (e.g., full name, dates of service) and identify the physician or non-physician practitioner responsible for care.
Submitted medical records must support the selected diagnosis code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Claims and coding must follow the Local Coverage Determination L37642 that this article complements; medical record documentation should support the billed service in accordance with LCD L37642.
All documentation must be maintained in the patient’s medical record and be legible with appropriate patient identification (e.g., complete name, dates of service) on every page.
The record must identify the physician or non-physician practitioner responsible for and providing the care to the patient.
The submitted medical record must support the selected diagnosis code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.

Key Coverage Criteria

Regional or local nerve blocks performed as an adjunct to, or as the sole means of, regional/local anesthesia for an operative procedure are not affected by this noncoverage policy (i.e., such intraoperative regional/local anesthesia is allowed).
CPT 64450 is appropriate when a qualified health care professional performs a direct injection (nerve block) of an anesthetic agent and/or steroid into a peripheral nerve for treatment of peripheral neuropathy.
Code 64450 addresses the additional work of performing a nerve block (direct peripheral nerve injection) rather than injections into surrounding subcutaneous tissue.
Peripheral nerve injection/nerve block for peripheral neuropathy may be covered when the medical record documents that the service is medically necessary for the patient's specific condition.
Use of acellular human dermal allograft in rhinoplasty
Healing septal perforations using acellular dermis as bioscaffold

20 Active Policies

CGS-L35249, Nerve Blocks for Peripheral Neuropathy

J15

A57589, Billing and Coding: Nerve Blocks for Peripheral Neuropathy

WPS-L35222, Nerve Blocks for Peripheral Neuropathy

NORIDIAN-L35456, Nerve Blockade for Treatment of Chronic Pain and Neuropathy

PALMETTO-JJ-L37642, Nerve Blocks and Electrostimulation for Peripheral Neuropathy

PALMETTO-JM-L37642, Nerve Blocks and Electrostimulation for Peripheral Neuropathy

BCBSMT-MED201.027, Electrostimulation and Electromagnetic Therapy for Treating Wounds

BCBSNM-MED201.027, Electrostimulation and Electromagnetic Therapy for Treating Wounds

BCBSOK-MED201.027, Electrostimulation and Electromagnetic Therapy for Treating Wounds

CARELON-physical-therapy-occupational-therapy-and-speech-therapy-2024-04-14, Physical Therapy Occupational Therapy and Speech Therapy

REGENCE-DME83.09, Electrical Stimulation for the Treatment of Wounds

CIGNA-0160, Electrical Stimulation Therapy and Devices in a Home Setting

EVICORE-HPLAN-EOCCO-CB04D09CF743, EOCCO Specialty Therapies Code List - Effective 05/01/2026

A56034, Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy

EVICORE-HPLAN-THE_HEALTH_PLAN-E178D78B53BA, The Health Plan MSK PTOT Code List - Effective 01/01/2026

A56731, Billing and Coding: Nerve Blocks and Electrostimulation for Peripheral Neuropathy

A57663, Billing and Coding: Nerve Blocks for Peripheral Neuropathy

AETNA-CPB-0244, Skin and Soft Tissue Substitutes

MED201.027, Electrostimulation and Electromagnetic Therapy for Treating Wounds

BCBSIL-MED201.027, Electrostimulation and Electromagnetic Therapy for Treating Wounds

Have a follow-up question?

Ask Verity about documentation requirements, denial risks, or coverage in your state.

G0282, Electrical stimulation, (unattended), to one or more areas, for wound care