BlueCross BlueShield of Tennessee Medical Policy Manual

Interferential Current Stimulation

DESCRIPTION

Interferential current stimulation (IFCS) is a type of electrical stimulation that uses paired electrodes of 2 independent circuits carrying high-frequency (4,000 Hz) and medium-frequency (150 Hz) alternating currents.  The superficial electrodes are aligned on the skin around the affected area.  There are no standardized protocols for the use of interferential current therapy.  The therapy may vary according to the frequency of stimulation, the pulse duration, treatment time, and electrode-placement technique.

IFCS has been investigated primarily as a technique to reduce pain.  IFCS has also been proposed to increase function of individuals with osteoarthritis and to treat other conditions such as dyspepsia, irritable bowel syndrome, and constipation.

Examples of interferential current stimulation devices include the: Medstar™ 100 (MedNet Services), SporTX Stimulator and the RS-4i® (RS Medical).

POLICY

Policies with similar titles:

IMPORTANT REMINDERS

ADDITIONAL INFORMATION

There is insufficient evidence from well-designed trials that interferential current stimulation (IFCS) improves health outcomes for individuals diagnosed with painful musculoskeletal conditions. The limited amount of evidence from a few small trials comparing IFCS alone to a placebo or sham intervention does not consistently show benefit. Some trials do not control for potential placebo effects, others do not adequately evaluate the incremental effects of IFCS beyond that of a co-intervention and/or do not adequately evaluate the equivalence of IFCS and an alternative intervention.  There is also insufficient evidence from well-designed trials that IFCS improves health outcomes for individuals diagnosed with conditions such as dyspepsia, irritable bowel syndrome, and constipation.  Therefore, interferential stimulation is considered investigational.

SOURCES

BlueCross BlueShield of Tennessee network providers. June-July 2011.

BlueCross BlueShield Association. Medical Policy Reference Manual. (12:2012). Interferential stimulation (1.01.24). Retrieved February 18, 2013 from BlueWeb. (12 articles and/or guidelines reviewed)

Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., et al. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annuals of Internal Medicine, 147 (7), 478-491.

Coban, S., Akbal, E., Koklu, S., Koklu, G., Ulasli, M. A., Erkec, S., et al. (2012). Clinical trial: Transcutaneous interferential electrical stimulation in individuals with irritable bowel syndrome - a prospective double-blind randomized study. Digestion, 86 (2), 86-93. Abstract retrieved February 18, 2013 from PubMed database. (Level 3 Evidence)

Fuentes, J. P., Armijo, Olivo, S., Magee, D. J., and Gross, D. P. (2010). Effectiveness of interferential current therapy in the management of musculoskeletal pain: A systematic review and meta-analysis. Physical Therapy, 90 (9), 1219-1238. Abstract retrieved February 9, 2011 from PubMed database.

Hayes. Medical Technology Directory. (2008, April; last update search April 2012). Interferential therapy for pain and bone fractures. Retrieved January 11, 2012 from www.hayesinc.com/subscribers. (32 articles and/or guidelines reviewed)

Kajbafzadeh, A. M., Sharifi-Rad, L., Nejat, F., Kaibafzadeh, M., & Talaei, H. R. (2012). Transcutaneous interferential electrical stimulation for management of neurogenic bowel dysfunction in children with myelomeningocele. International Journal of Colorectal Disease, 27 (4), 453-458.  Abstract retrieved February 18, 2013 from PubMed database.(Level 3 Evidence)

Koklu, S., Koklu G, Ozguclu, E., Ozquclu, E., Davani, G. U., Akbal, E., & Hascelik, Z. (2010). Clinical trial: Interferential electric stimulation in functional dyspepsia patients - a prospective randomized study. Alimentary  Pharmacology & Therapeutics, 31 (9), 961-968. Abstract retrieved February 18, 2013 from PubMed database. (Level 3 Evidence)

National Guideline Clearinghouse. American College of Occupational and Environmental Medicine. Chronic pain. Retrieved February 17, 2011 from http://www.guidelines.gov/content.aspx?id=14284&search=american+college+of+occupational+and+environmental+medicine.+chronic+pain.

ORIGINAL EFFECTIVE DATE:  3/1/2000   

MOST RECENT REVIEW DATE:  6/8/2013  

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Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

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