CMM-603: Electrical and Low Frequency Ultrasound Bone Growth Stimulation (Spine) Guidelines

Invasive (intraoperative) or noninvasive electrical bone growth stimulation is covered only when used with an approved spinal fusion in patients at high risk for pseudarthrosis (one or more listed risk factors), and noninvasive stimulation for failed fusion is covered only after ≥6 months post‑op with serial imaging showing no progression for 3 months; electrical stimulation (invasive or noninvasive) is not covered for lumbar spondylolysis, failed disc arthroplasty, spinal malignancy, nonsurgical treatment of established pseudarthrosis, or for semi‑invasive/low‑intensity ultrasound for any spinal indication. Requests are determined case‑by‑case with required documentation (including supporting imaging and a DEXA within one year if citing osteoporosis), prior authorization as applicable, and an urgent/emergent timeline exception that excludes primary or metastatic neoplastic disease.

"Invasive (inserted at the time of surgery) or noninvasive (beginning at any time from the time of surgery until up to 6 months after surgery with the exception of this timeline for an urgent/emerge..."