CMM-211: Spinal Cord Stimulators

Dorsal column spinal cord stimulation (SCS) is medically necessary on a case‑by‑case basis for FBSS, CRPS/RSD, chronic critical limb ischemia and chronic stable angina only after a >48‑hour trial, mental‑health evaluation, and required prior therapy/documentation (for FBSS and CRPS: ≥6 months of failed conservative care and ≥50% pain reduction during trial [FBSS also requires surgery be not indicated or refused]; for CLI/angina: documented "beneficial clinical response" to temporary electrode, and for angina CCS class III/IV with cardiologist attestation that revascularization is not suitable and optimal medications have failed). Dorsal root ganglion stimulation, peripheral nerve/field stimulation, burst or other generator modes beyond tonic low/high frequency, high‑frequency SCS for indications other than FBSS, many other pain indications (e.g., post‑amputation, post‑herpetic neuralgia, peripheral neuropathy), and replacing a functioning non‑HF device with an HF device are considered experimental/investigational and not covered.