Interferential stimulation is experimental/investigational. Review of available literature reveals a lack of controlled clinical trials that prove the effectiveness of the procedure. As such, interferential stimulator devices and any related supplies (e.g., electrodes [A4556], lead wires [A4557]) used in the home and clinical setting are not covered. A participating, preferred, or network provider can bill the member for the denied service.

For additional information, see Medical Policy Bulletin Y-1.

Description

Interferential stimulation is a type of electrical nerve stimulation that uses paired electrodes of two independent circuits carrying medium-frequency alternating currents. The electrodes are aligned on the skin so that the current flowing between each pair intersects at the underlying target. This maximizes the current permeating the tissues while minimizing unwanted stimulation of cutaneous nerves.

NOTE:

This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition. Each person's unique clinical circumstances may warrant individual consideration, based on review of applicable medical records.

This medical policy may not apply to FEP. Medical policy is not an authorization, certification, explanation of benefits, or a contract. Benefits are determined by the Federal Employee Program.

The effects of home interferential therapy on post-operative pain, edema, and range of motion of the knee, Jarit GJ, Clin J Sport Med, 01-JAN-2003; 13(1): 16-20

Zambito A, et al. Interferential and horizontal therapies in chronic low back pain due to multiple vertebral fractures: a randomized, double blind, clinical study. Osteoporos Int. 2007 Nov;18(11):1541-5. Epub 2007 Jul 4.

Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-91.

Poitras S, Brosseau L. Evidence-informed management of chronic low back pain with transcutaneous electrical nerve stimulation, interferential current, electrical muscle stimulation, ultrasound, and thermotherapy. Spine J. 2008;8(1):226-33.

Rutjes AWS, Nüesch E, Sterchi R, Kalichman L, Hendriks E, Osiri M, Brosseau L, Reichenbach S, Jüni P. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No:CD002823. DOI:10.1002/14651858. CD002823. pub2.

Fuentes JP, Armijo Olivo S, Magee DJ, et al. Effectiveness of interferential current therapy in the management of musculoskeletal pain: A systematic review and meta-analysis. Phys Ther. 2010;90(9):1219-38.