PDFWAC 182-543-3300

Covered—Osteogenesis electrical stimulator (bone growth stimulator)—Noninvasive.

(1) The medicaid agency covers, with prior authorization, noninvasive osteogenesis electrical stimulators, also known as bone growth stimulators, limited to one per client, in a five-year period.
(2) The agency pays for the purchase of nonspinal bone growth stimulators, only when:
(a) The stimulators have pulsed electromagnetic field (PEMF) stimulation; and
(b) The client meets one or more of the following clinical criteria:
(i) Has a nonunion of a long bone fracture (which includes clavicle, humerus, phalanx, radius, ulna, femur, tibia, fibula, metacarpal and metatarsal) where three months have elapsed since the date of injury without healing; or
(ii) Has a failed fusion of a joint, other than in the spine, where a minimum of nine months has elapsed since the last surgery; or
(iii) Diagnosed with congenital pseudarthrosis.
(3) The agency pays for the purchase of spinal bone growth stimulators, when:
(a) Prescribed by a neurologist, an orthopedic surgeon, or a neurosurgeon; and
(b) The client meets one or more of the following clinical criteria:
(i) Has a failed spinal fusion where a minimum of nine months has elapsed since the last surgery; or
(ii) Is post-op from a multilevel spinal fusion surgery; or
(iii) Is post-op from spinal fusion surgery and there is a history of a previously failed spinal fusion.
(4) The agency pays for the purchase of ultrasonic noninvasive bone growth stimulators when:
(a) Prescribed by a neurologist, an orthopedic surgeon, or a neurosurgeon; and
(b) The client meets all the following clinical criteria:
(i) Nonunion confirmed by two radiographs minimum 90 days apart; and
(ii) Physician statement of no clinical evidence of fracture healing.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 24-17-001, § 182-543-3300, filed 8/8/24, effective 9/8/24. Statutory Authority: RCW 41.05.021 and 2013 c 178. WSR 14-08-035, § 182-543-3300, filed 3/25/14, effective 4/25/14. WSR 11-14-075, recodified as § 182-543-3300, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090 and 74.04.050. WSR 11-14-052, § 388-543-3300, filed 6/29/11, effective 8/1/11.]