Change in Billing for Instruction on the Use of a Transcutaneous Neurostimulator (TENS) Unit

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Categories: Medical Provider All News Medical Provider Billing Medical Provider Utilization Review

Effective for dates of service on and after January 1, 2019, WSI has implemented a new code, W0420, for a provider to bill when instructing an injured worker on the use of a TENS unit. The W0420 code replaces code 64550 (Application of surface neurostimulator), which was deleted from the Current Procedural Terminology (CPT®) codebook for 2019.

When a provider bills a W0420 code, WSI requires written documentation regarding instruction on the TENS unit to accompany the bill. The reimbursement amount for W0420 in 2019 is $20.00. Reimbursement for WSI for TENS instruction is in addition to any reimbursement offered by the TENS supplier.

The following is a reminder of the standard process involving the prescription for a TENS unit:

  • The treating provider submits a Electro Medical Device Certification Request (M5) form, along with a prescription for a TENS unit to WSI.
  • WSI reviews the request for medical necessity.
  • If the request is approved, CPR Medical coordinates mailing of the TENS unit to the appropriate party, i.e. rendering provider or directly to the injured worker.
  • WSI reimburses CPR Medical for the TENS unit.
  • CPR Medical may offer a voucher to the rendering provider to instruct the injured worker on use of the TENS unit.

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