Prescription Info

Sample format and codes that your physician will need are as follows:

1. Diagnosis: Chronic Intractable Pain (DX Code – G89.4)
2. Other Possible Diagnosis Codes: Other Chronic Pain (DX Code – G89.29) and Unspecified Idiopathic Peripheral Neuropathy (DX Code – G60.9 DX Code – 90.09)
3. Sample Rx Language: ReBuilder Model 300 (DME Code E0720) for treatment of chronic pain, ReBuilder Model 2407 (DME Code E0730) for treatment of chronic pain.
4. Description for ReBuilder is: TENS/EMS, ReBuilder, brand specific for chronic pain (No Generic Substitutions)