Functional Electrical Stimulation (FES) and Neuromuscular Electrical Stimulation (NMES) - DME.ST.113.A

Covers NMES (E0745) for disuse muscle atrophy when the nerve to the muscle is intact, and FES (E0764/E0770, including Parastep I) to enable ambulation in specified spinal cord injury cases, post‑stroke foot drop, and NYHA class III–IV heart failure; conductive garments (E0731) are covered only when conventional electrodes are contraindicated, while implanted neurostimulators and other uses (general strengthening, knee OA, upper‑extremity hemiplegia, oropharyngeal dysphagia) and certain disposable items are excluded or considered experimental/not DME. Key requirements: thorough documentation that all indication‑specific clinical criteria are met (e.g., intact lower motor units L1 and below, brisk NMES response and sensory perception, independent transfer/standing ability, ≥6 months post‑injury and completion of PT for SCI; adequate passive ankle ROM for foot drop; NYHA III/IV for heart failure), absence of listed contraindications (e.g., pacemaker/ICD, pregnancy, epilepsy, severe scoliosis/osteoporosis, skin disease/cancer at stimulation site, irreversible contracture, autonomic dysreflexia), demonstration of ability/training to use the device, and compliance with rental/purchase supply billing rules.