Spinal Cord Stimulators - Medicare Advantage

This policy addresses coverage of spinal cord stimulation systems — including fluoroscopically guided temporary (trial) lead placement and subsequent implantation of permanent leads and an implantable pulse generator — for treatment of chronic intractable pain under Medicare Advantage. It applies to adult patients with conditions such as failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS), requires a staged outpatient trial with temporary electrodes and ≥50% pain reduction to proceed to permanent implantation, and is subject to Medicare NCD 160.7 and the referenced LCDs (L35136, L36204, L37632) for specific limitations and exclusions.

"Implicit exclusion of pediatric patients (only adults mentioned)."

Sign up to see full coverage criteria, indications, and limitations.