Electrical stimulation, also known as electrostimulation, refers to the application of electrical current through electrodes placed directly on the skin. Electromagnetic therapy involves the application of electromagnetic fields rather than direct electrical current. Both are proposed as treatments for wounds, generally chronic wounds.
Electrical stimulation is covered for the management of the following types of chronic ulcers when it is used as adjunctive therapy after there are no measurable signs of healing for at least 30 days of treatment with conventional wound treatments (Electrical stimulation will not be covered as an initial treatment modality.):
- Arterial ulcers
- Diabetic ulcers
- Pressure ulcers (Stage III or Stage IV)
- Venous stasis ulcers
A course of electrical stimulation therapy for chronic ulcers would not typically be expected to exceed 60 minutes per day, or a total duration of more than one month. Courses of electrical stimulation therapy for chronic ulcers exceeding 60 minutes per day are not considered medically necessary, as prolonged treatments beyond 60 minutes per day have not been proven to offer additional clinically significant benefits.
Continued treatment is not covered if measurable signs of healing have not been demonstrated within any 30-day period of treatment. Measurable signs of improved healing include a decrease in wound size either in surface area or volume, decrease in amount of exudates, and decrease in amount of necrotic tissue. If electrical stimulation is being used, wounds must be evaluated at least monthly by the treating physician.
All other uses of electrical stimulation for the treatment of chronic ulcers will be denied as not medically necessary and, therefore, not covered.
Electrical stimulation for wound healing is not covered in the home setting, as unsupervised use by patients in the home has not been found to be medically necessary. Therefore, payment will not be made for an electrical stimulation device used to treat wounds.