(1) The medicaid agency covers, with prior authorization, noninvasive osteogenesis electrical 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) simulation; 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.
(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 have 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.
[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.]