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MA05.006k, Transcutaneous Electrical Nerve Stimulators (TENS) and Associated Supplies
Act
by Oct 1, 2025
Effective date
Oct 1, 2025
Identified
Jun 19, 2026
Summary
Independence Blue Cross updated MA05.006k to MA05.006l, effective 10/01/2025, replacing the broad ICD-10 code R10.2 (pelvic and perineal pain) with four more specific codes (R10.21, R10.22, R10.23, R10.24) for TENS device coverage criteria. This is an ICD-10 code maintenance update that requires billing teams to use laterality-specific and anatomically precise codes when documenting TENS eligibility for pelvic/perineal pain conditions.
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What to do
by Oct 1, 2025 · 5 steps
01Billing team must update claim submission workflows and ICD-10 code mapping tables to discontinue use of R10.2 (pelvic and perineal pain) and replace it with the appropriate laterality-specific code: R10.21 (right side), R10.22 (left side), R10.23 (bilateral), or R10.24 (suprapubic pain).
02Update encounter documentation templates and EMR systems to reflect these new codes.
03Verify that prior authorization and claims adjudication systems reflect the new codes to prevent denials.
04Educate providers and front desk staff on proper code selection based on documented pain location.
05Claims submitted after 10/01/2025 using the deleted code R10.2 may be denied or require correction.
Codes mentioned
E0720E0730A4556A4557A4558A4595A4630R10.21R10.22R10.23R10.24G89.12G89.18G89.21G89.29G89.3G89.4
Original notice
MA05.006k, Transcutaneous Electrical Nerve Stimulators (TENS) and Associated Supplies
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →05.00.74k, Transcutaneous Electrical Nerve Stimulators (TENS) and Associated SuppliesLowEffective Oct 1, 2025 · Medical PolicyMA05.006l, Transcutaneous Electrical Nerve Stimulators (TENS) and Associated SuppliesMediumEffective Dec 29, 2025 · Medical Policy05.00.74l, Transcutaneous Electrical Nerve Stimulators (TENS) and Associated SuppliesLowEffective Dec 29, 2025 · Medical Policy05.00.74l, Transcutaneous Electrical Nerve Stimulators (TENS) and Associated SuppliesMediumEffective Dec 29, 2025 · Medical PolicyBrowse every Independence Blue Cross change in the policy list
Related policy hubs
Independence Blue Cross policiesPain ManagementPhysical TherapyPM&R (Physical Medicine & Rehab)OrthopedicsGeneral SurgeryNeurologyOncologyCode E0720Code E0730Code A4556Code A4557Code A4558Code A4595Code A4630Code R10.21Code R10.22Code R10.23Code R10.24Code G89.12Code G89.18Code G89.21Code G89.29Code G89.3Code G89.4