Q68.4 — Congenital bowing of tibia and fibula
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is 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 — CG-DME-40 Noninvasive Electrical Bone Growth Stimulation of the Appendicular Skeleton
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