Peripheral Nerve Stimulation

Peripheral nerve stimulation (PNS) is covered for select chronic, intractable neuropathic pain conditions (e.g., occipital neuralgia, trigeminal neuropathic facial pain, CRPS, post-surgical neuropathic pain) after failure of conservative therapies and a documented successful temporary stimulation trial (≥50% pain or medication reduction with functional improvement). Peripheral nerve field stimulation (PNFS) is not covered for any condition, and PNS is specifically not covered for fibromyalgia, phantom limb pain, diffuse polyneuropathy, nociceptive trunk/lower back pain, or angina; documentation requirements, setting and physician qualifications apply and repeat trials are restricted.

"PNS may be covered for relief of chronic, intractable neuropathic pain in patients with conditions known to be responsive to PNS after appropriate attempts to cure underlying conditions and prior t..."