Notification Number: 3418
Effective date: 2/1/2018
Notification date: 11/3/2017
Topic: Electrical stimulators for pain and nausea/vomiting
We will not reimburse charges for these electrical stimulator implantation procedures:
Humana considers electrical stimulators to be experimental or investigational; therefore, they are not covered.
For more information, please review Humana's Electrical Stimulators for Pain and Nausea/Vomiting medical coverage policy. To locate the policy, go to Humana's Medical and Pharmacy Coverage Policies and search for “pain and nausea.”
Note: Humana's electrical stimulators for pain and nausea/vomiting policy is scheduled to be updated to indicate that the listed codes are not covered for treatment of pain and nausea/vomiting because the treatment is experimental or investigational. The update will be effective Feb. 1, 2018.
Claim edits do not supersede the necessity to obtain preauthorization. Preauthorization requirements are still applicable. Modifiers should be used when appropriate to accurately represent the services rendered. The use of modifiers may impact Humana’s application of these edits. For additional information, consult professional coding resources.
*All edits previously posted on Humana.com/providers for fully insured commercial Humana members may be applied to self-funded members, when requested by the self-funded group.