Osteogenesis Stimulators - Policy Article

Osteogenesis stimulators may be covered under Medicare's DME benefit only if they meet DME benefit eligibility and the reasonable and necessary criteria in the related LCD; suppliers must comply with Final Rule 1713 face-to-face and Written Order Prior to Delivery requirements for specified HCPCS codes. Special documentation rules apply (CMN changes effective 1/1/2023, retain evidence for KX modifier, ABN use for GA/GZ), certain devices (E0747, E0748, E0760) require KF modifier, and invasive stimulators are not processed by the DME MAC.

"Osteogenesis stimulators are covered under the Durable Medical Equipment (DME) benefit when the device and use meet Medicare DME benefit eligibility and the reasonable and necessary (R&N) requireme..."

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