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ICD-10-CM Q68.4, Congenital bowing of tibia and fibula | No Prior Auth

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`Q68.4`, Congenital bowing of tibia and fibula

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Key Coverage Criteria

Noninvasive electrical bone growth stimulation is consideredmedically necessarywhenallof the following criteria are met:Treatment is for either of the following:Fracture nonunion of any bone of the appendicular skeleton;orCongenital pseudoarthroses of any bone of the appendicular skeleton;andAt least 45 days have passed since either of the following:The date of fracture;orThe date of appropriate fracture care;andNo progressive signs of healing have occurred on imaging studies (for example, bony [...]
Treatment is for either of the following:Fracture nonunion of any bone of the appendicular skeleton;orCongenital pseudoarthroses of any bone of the appendicular skeleton;and
Fracture nonunion of any bone of the appendicular skeleton;or
Congenital pseudoarthroses of any bone of the appendicular skeleton;and
At least 45 days have passed since either of the following:The date of fracture;orThe date of appropriate fracture care;and
The date of fracture;or

1 Active Policy

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

Related Codes

20975(1 policies)E0747(1 policies)E0748(1 policies)E0749(1 policies)M96.0(1 policies)Q68.3(1 policies)Q68.5(1 policies)20974(1 policies)

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