E0760, Osteogenesis stimulator, low intensity ultrasound, non-invasive
HCPCS/CPT
Prior Authorization
Prior Auth Required
Code explicitly requires prior authorization (high confidence)
Documentation Required
- 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.
- For refills, the supplier must contact the beneficiary (no sooner than 30 calendar days prior to expected end of current supply), document an affirmative response, and deliver the refill no sooner than 10 calendar days prior to expected end of current supply.
- Suppliers must document verification with the treating practitioner when changed or atypical utilization patterns are observed and must not dispense quantities exceeding expected utilization.
Key Coverage Criteria
- 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.
18 Active Policies
EVICORE-MSK_ADVANCED-9A54860D, CMM-603: Electrical and Low Frequency Ultrasound Bone Growth Stimulation (Spine) Guidelines
ANTHEM-CG-DME-45, CG-DME-45 Ultrasound Bone Growth Stimulation
L33796, Osteogenesis Stimulators
UHC-POL-electrical-ultrasound-bone-growth-stimulators, Electrical and Ultrasonic Bone Growth Stimulators
AETNA-CPB-0343, Bone Growth Stimulators
AMBETTER-CP.MP.194, Osteogenic Stimulation
BCBSOK-DME101.030, Ultrasonic Osteogenesis Stimulator
REGENCE-DME83.12, Ultrasonic Bone Growth Stimulators (Osteogenic Stimulation)
UMR-POL-UMR-electrical-ultrasound-bone-growth-stimulators, Electrical and Ultrasonic Bone Growth Stimulators
SUREST-POL-SUREST-electrical-ultrasound-bone-growth-stimulators, Electrical and Ultrasonic Bone Growth Stimulators
EVICORE-HPLAN-CIGNA-3C6BF790C032, Cigna Commercial DME Code List - Effective 03/07/2026
EVICORE-HPLAN-CIGNA-1815296EE67F, Cigna Comprehensive Code List - Effective 03/07/2026
EVICORE-HPLAN-CIGNA-FE6FBAF45728, Cigna Commercial Joint Surgery Code List - Effective 03/07/2026
EVICORE-HPLAN-CIGNA-5EF639BE0AD8, Cigna Commercial Spine Surgery Code List - Effective 03/07/2026
BCBSIL-DME101.030, Ultrasonic Osteogenesis Stimulator
BCBSMT-DME101.030, Ultrasonic Osteogenesis Stimulator
BCBSNM-DME101.030, Ultrasonic Osteogenesis Stimulator
DME101.030, Low Intensity Pulsed Ultrasound Fracture Healing Device
Related Codes
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