La. Admin. Code tit. 50 § XVII-10503
Current through Register Vol. 50, No. 11, November 20, 2024
Section XVII-10503 - Medical NecessityA. Spinal noninvasive electrical bone growth stimulators may be considered: 1. when a minimum of nine months has elapsed since the patient has had fusion surgery which has resulted in a failed spinal fusion;2. when there is a history of a previously failed spinal fusion at the same site following spinal fusion surgery and more than nine months has elapsed since fusion surgery was performed at the same level which is being fused again. As long as nine months has passed since the failed fusion surgery, this repeated fusion attempt requires no minimum passage of time for the application of the device; or3. following a multi-level spinal fusion (i.e., involving three or more contiguous vertebrae, such as L3-L5 or L4-S1). There is no minimum time for application after this surgery.B. Nonspinal noninvasive ultrasonic bone growth stimulators may be considered for nonunion fractures when a minimum of two sets of radiographs, one before treatment and a second separated by 90 days, are obtained. These radiographs shall include multiple views and be accompanied by a written interpretation by a physician stating that there has been no clinically significant evidence of fracture healing between the two sets of radiographs.C. Nonspinal noninvasive electrical bone growth stimulators may be considered: 1. when long bone fractures have failed to heal and a period of six months from the initial date of treatment has elapsed;2. when a long bone fusion has failed and a period of nine months from the initial date of treatment has elapsed; or3. for the treatment of congenital pseudoarthroses. There is no minimal time requirement after this diagnosis.La. Admin. Code tit. 50, § XVII-10503
Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 37:1601 (June 2011).AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.