Does E0748 require prior authorization?

No, E0748 does not require prior authorization (high confidence). Code is covered without prior authorization.

`E0748` — Osteogenesis stimulator, electrical, non-invasive, spinal applications

HCPCS/CPT

No Prior Auth Required

Code is covered without 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.
Proof of delivery (POD) documentation must be maintained by the supplier and made available to the Medicare contractor upon request.

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.

L33796 — Osteogenesis Stimulators

J19

UHC-POL-electrical-ultrasound-bone-growth-stimulators — Electrical and Ultrasonic Bone Growth Stimulators

AETNA-CPB-0343 — Bone Growth Stimulators

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

CARELON-spine-surgery-2024-01-01

Ask Verity about documentation requirements, denial risks, or coverage in your state.