Peripheral Nerve Stimulation

PNS is covered for neuropathic and chronic intractable pain from peripheral nerve injury—including upper/lower extremity nerves, intercostal and ilio‑inguinal nerves, occipital and trigeminal distributions, painful amputation neuromas, post‑surgical scar pain, nerve entrapment, mononeuropathy, and CRPS types 1 and 2—but is explicitly not covered for fibromyalgia, phantom limb pain, diffuse polyneuropathy, nociceptive trunk/lower back pain, angina pectoris, or peripheral nerve field stimulation (PNFS). Key requirements: failure of conservative treatments and ≥3 months of severe pain; a documented trial (≤4 leads/16 contacts, max two CPT 64555 services per 365 days) with ≥50% pain or analgesic reduction plus functional improvement before permanent implantation in an ASC/hospital; appropriate physician credentials, psychological screening/no active substance abuse, informed consent and complete chart/imaging documentation (with post‑payment review for low trial‑to‑implant ratios or unjustified repeat trials).