Does E0747 require prior authorization?

Yes, E0747 requires prior authorization (high confidence). At least one active policy explicitly requires prior authorization.

`E0747`, Osteogenesis stimulator, electrical, non-invasive, other than spinal

HCPCS/CPT

Prior Auth Required

At least one active policy explicitly requires prior authorization (high confidence)

A Standard Written Order (SWO) must be communicated to the supplier before a claim is submitted for the item; claims without a completed SWO shall be denied.
For DMEPOS base items that require a Written Order Prior to Delivery (WOPD), the supplier must have a signed WOPD before delivering the item; the WOPD may list associated options/accessories/supplies.
Nonunion of a long-bone fracture must be documented by a minimum of two sets of radiographs obtained prior to starting treatment, separated by at least 90 days, each with multiple views of the fracture site and a treating practitioner’s written interpretation stating no clinically significant evidence of healing between the two sets.

Non-spinal electrical osteogenesis stimulator (HCPCS E0747) is covered for nonunion of a long-bone fracture when there is radiographic evidence that fracture healing has ceased for at least 3 months prior to starting treatment.
Non-spinal electrical osteogenesis stimulator (HCPCS E0747) is covered for failed fusion of a joint other than the spine when a minimum of 9 months has elapsed since the last surgery.
Non-spinal electrical osteogenesis stimulator (HCPCS E0747) is covered for congenital pseudarthrosis.
Spinal electrical osteogenesis stimulator (HCPCS E0748) is covered for failed spinal fusion when a minimum of 9 months has elapsed since the last spinal surgery.
Spinal electrical osteogenesis stimulator (HCPCS E0748) is covered when used following a multilevel spinal fusion surgery.
Spinal electrical osteogenesis stimulator (HCPCS E0748) is covered following spinal fusion surgery when there is a history of a previously failed spinal fusion at the same site.

ANTHEM-CG-DME-40, Noninvasive Electrical Bone Growth Stimulation of the Appendicular Skeleton

EVICORE-HPLAN-CIGNA_MEDICARE-268F28B96146, Cigna Medicare Advantage Durable Medical Equipment Code List - Effective 01/01/2025

L33796, Osteogenesis Stimulators

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AETNA-CPB-0343, Bone Growth Stimulators

AMBETTER-CP.MP.194, Osteogenic Stimulation

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BCBSMT-SUR705.044, Electrical Bone Growth Stimulation of the Appendicular Skeleton

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