Electrical Bone Growth Stimulation (Spine) - DME.ST.109.A

Noninvasive electrical bone growth stimulation is covered as an adjunct to an approved spinal fusion for patients at high risk for pseudarthrosis (e.g., BMI>30, smoking, diabetes/renal/metabolic disease, glucocorticoid dependence, multi‑level fusion ≥3 levels, prior failed fusion, osteoporosis with DEXA T‑score ≤ −2.5, etc.) and as treatment for failed fusion only when ≥6 months have passed since surgery with 3 months of serial imaging showing no progression; it is excluded/considered investigational for lumbar spondylolysis, failed disc arthroplasty, spinal malignancy, nonsurgical treatment of established pseudarthrosis, and neoplastic spinal disease. Coverage requires documentation of the approved fusion (operative report), clinical evidence of listed risk factors (DEXA within one year if citing osteoporosis), and for failed fusion explicit timing and serial imaging proving non‑healing; urgent/emergent timing exceptions apply except for primary or metastatic neoplastic disease.