CMM-615 Electrical and Low Frequency US Bone Growth Stimulation Spine

Electrical bone growth stimulation (invasive or non‑invasive) is covered as an adjunct to an approved spinal fusion for patients at high risk for pseudarthrosis (e.g., AUD, BMI>30, diabetes/renal/metabolic disease, chronic glucocorticoid use, Meyerding ≥III, ≥3‑level fusion, malnutrition, prior failed fusion, DEXA T‑score <‑1.0, severe anemia, smoking, immunocompromise) or as non‑invasive treatment of a failed fusion ≥6 months post‑op with serial imaging showing no progression for 3 months; it is excluded for lumbar spondylolysis, failed disc arthroplasty, spinal malignancy, non‑surgical treatment of established pseudarthrosis, and semi‑invasive/low‑intensity ultrasound (experimental). Required documentation includes operative authorization and evidence of the listed risk factor(s) or ≥6 months elapsed plus imaging demonstrating non‑healing, adherence to timing limits (treatment up to 6 months post‑op for at‑risk fusions, after 6 months for failed fusions), and prior authorization per CMM‑600.1, with case‑by‑case review for atypical or urgent/emergent cases.