LETTER OF MEDICAL NECESSITY. Medical Justification:. I certify that the TENS, Transcutaneous Electrical Nerve Stimulation, unit that I have prescribed for .
(Where the letter is typed and you hand write the blank information] Form letters do not work because it appears. Letter of Medical necessity for a TENS unit.
______ EMS Unit and Supplies. LETTER OF MEDICAL NECESSITY. and substantiate the medical necessity of a TENS unit and supplies for pain control.
Note: When used for the treatment in section II, the TENS unit must be used by. Letter of medical necessity, notes wrote on letter head or prescriptions are not .
certify that the medical necessity information in Section B is true, accurate and complete,. Is the TENS unit being prescribed for any of the following conditions
TENS devices consist of an electrical pulse generator, usually battery operated,. . BCBSNC may request medical records for determination of medical necessity.. requested, letters of support and/or explanation are often useful, but are not .