DME.00049 External Upper Limb Stimulation for the Treatment of Tremors

This policy addresses wrist-worn external upper limb tremor stimulation devices used to treat hand tremors. Anthem deems these devices investigational and not medically necessary for all indications and therefore not covered, including use for essential tremor and Parkinson’s disease. Non-coverage applies in all clinical scenarios and to items billed under HCPCS codes A4542, E0734, K1018, and K1019.

"Wrist-worn external upper limb tremor stimulator is consideredinvestigational and not medically necessaryfor all indications, including but not limited to the treatment of essential tremor of the h..."

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