Electrical Bone Growth Stimulation of the Appendicular Skeleton
SUR705.044
This policy covers electrical bone growth stimulation (EBGS) of the appendicular skeleton to promote healing for delayed unions, fracture nonunions, failed arthrodesis/fusion, and congenital pseudoarthrosis—generally when there is no clinical or radiographic progression of healing for at least 3 months (or by FDA nonunion criteria). Coverage is limited to appendicular sites and is subject to the member’s benefit plan and state rules; many other uses (eg, fresh fractures <14 days, stress fractures, immediate postoperative treatment) and implantable/semi‑invasive EBGS approaches are considered experimental, investigational, or unproven.
"Delayed unions of fractures or failed arthrodesis at high-risk sites (examples: open or segmental tibial fractures, carpal navicular fractures, 5th metatarsal fractures, distal radius fractures)."
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