National Coverage Analysis (NCA) Tracking Sheet

Neuromuscular Electrical Stimulation (NMES) for Spinal Cord Injury

CAG-00153R

Issue

Neuromuscular electrical stimulation (NMES) devices provide artificial electrical stimulation of muscles to produce movements such as standing and walking. The Centers for Medicare and Medicaid Services(CMS) issued a national coverage policy (CIM § 35-77) in 1984 for the use of these devices for the treatment of disuse atrophy where nerve supply to the muscle is intact, including brain, spinal cord and peripheral nerves. Treatment for disuse atrophy that results from spinal cord injury or other neurological disorders is not covered. This policy was re-examined and reaffirmed in 1991.

CMS has been made aware of additional material and clinical evidence that was not considered in our 1991 review regarding NMES for spinal cord injured patients to enable standing and walking. Therefore, CMS has internally generated a reconsideration of CIM § 35-77 to determine whether or not the use of NMES for spinal cord injury to enable standing and walking is reasonable and necessary.

Benefit Category

No Benefit Category

Requestor Information

Requestor Name Requestor Letter
Internally Generated Request N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
04/19/2002
Expected NCA Completion Date
07/22/2002
Public Comment Period
05/20/2002 - 06/20/2002
Proposed Decision Memo Due Date
04/19/2002
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released
07/22/2002

Contacts

Lead Analysts
Jackie Sheridan-Moore
Lorrie Ballantine
Lead Medical Officers

Medicare Benefit Category Determination Date

Actions Taken

July 22, 2002

CMS posts decision memorandum announcing our intent to issue a positive national coverage determination.

November 2002

Claims Processing Instructions issued and NCD updated