Before 2026-07-30: Billing and clinical teams must review and implement the following: (1) For FES devices (Parastep I System): Verify prior authorization requires documentation of all 9 medical necessity criteria including intact lower motor units, joint stability, successful completion of 32+ PT sessions, and absence of contraindications (cardiac pacemakers, severe scoliosis/osteoporosis, skin disease, irreversible contracture, autonomic dysreflexia). Do not process claims without this documentation. (2) For NMES devices: Limit coverage to disuse atrophy cases with intact nerve supply and specific non-neurological reasons (burn contractures, failed post-knee surgery PT, post-casting/splinting, pre-PT hip replacement). Flag claims exceeding 2 hours per 24-hour period as not medically necessary. (3) For form-fitting conductive garments (Empi Phoenix, KneeHab, QB1): Require FDA approval documentation and confirmation that patient cannot manage with conventional electrodes/tapes/lead wires due to stimulation site area, frequency, skin conditions, or casting needs. (4) For diaphragmatic/phrenic pacing systems: Verify specific indications (high C-3+ quadriplegia with viable phrenic nerves, central alveolar hypoventilation, or ALS with chronic hypoventilation) and document 4+ hour continuous breathing without mechanical ventilation. (5) For Vocare Bladder System: Confirm clinical complete spinal cord lesion, proper timing (3+ months post-injury for females, 9+ months for males), cystometry pressures, and 3+ non-vesical sacral reflexes. (6) For Remede phrenic nerve stimulation: Ensure patient failed oxygen, pharmacotherapy, and CPAP/BiPAP for central sleep apnea. (7) Mark as experimental/unproven and deny: FES upper extremities (all indications including stroke, TBI, Parkinson's), NMES for Bell's palsy, cardiac conditioning, cerebral palsy, COPD, CHF, erectile dysfunction, foot drop (except SCI), general strengthening, progressive disease muscle atrophy, post-cardiac surgery, masseter dysfunction, and all other non-specified indications. Update prior authorization workflows, claim scrubbing rules, and denial templates in billing system. Train providers and billing staff on documentation requirements. Communicate policy changes to patients to prevent claim denials.