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

Covered: invasive or non‑invasive electrical bone growth stimulation is medically necessary when performed with an approved spinal fusion for patients at high risk of pseudoarthrosis within 6 months post‑op (risk factors include alcohol use disorder, BMI>30, diabetes/renal/metabolic disease, chronic glucocorticoid use, Meyerding Grade III+, multi‑level fusion ≥3 levels, malnutrition, prior failed fusion, osteoporosis/osteopenia [T‑score <‑1.0], severe anemia, smoking, or immunocompromise) or as non‑invasive therapy for failed fusion ≥6 months after surgery when serial imaging shows no progression of healing over a 3‑month interval. Excluded/limits and key requirements: low‑intensity ultrasound is not covered, semi‑invasive stimulation is investigational, and stimulation is not covered for lumbar spondylolysis, failed disc arthroplasty, spinal malignancy, or as non‑surgical treatment of established pseudoarthrosis; coverage requires documentation of the fusion procedure, specified risk factors (including a recent DEXA if citing osteoporosis), required imaging/timing for failed fusions, prior authorization, and case‑by‑case medical necessity determination.