About this policy
CMS NCA document | source_status=Closed | review_type=New | public_comment_open=False | document_id=CAG-00022N
Coverage indications
Rescind the national noncoverage policy for Ultrasonic Osteogenic Stimulators. Amend CIM 35-48 to state: B. Ultrasonic Osteogenic Stimulators .An ultrasonic osteogenic stimulator is a non-invasive device that emits low intensity, pulsed ultrasound. The ultrasound signal is applied to the skin surface at the fracture location via ultrasound, conductive, coupling gel in order to stimulate fracture healing. Ultrasonic osteogenic stimulators are covered as medically reasonable and necessary for the treatment of fractures only when the following conditions are met: Nonunion of a fracture must be documented by a minimum of two sets of radiographs obtained prior to starting treatment with the osteogenesis stimulator, separated by a minimum of 90 days, each including multiple views of the fracture site, and with a written interpretation by a physician stating that there has been no clinically significant evidence of fracture healing between the two sets of radiographs. Patient must have documented failure of at least one surgical intervention for the treatment of the fracture. Nonunions of the skull, vertebrae, and those that are tumor-related are excluded from coverage. The ultrasonic osteogenic stimulator may not be used concurrently with other noninvasive osteogenic devices. The national noncoverage policy relating to ultrasonic osteogenic stimulators for fresh fractures and delayed unions remains in place. This policy relates only to nonunion as defined above.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.