Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · OrthopedicsMedium impact
Electrical Bone Growth Stimulation of the Appendicular Skeleton
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Noninvasive electrical bone growth stimulation may be considered medically necessary for fracture nonunions or congenital pseudarthrosis in the appendicular skeleton, which includes the shoulder girdle, upper extremities, pelvis and lower extremities. The nonunion must meet all of these criteria: at least 3 months have passed since the date of fracture, serial radiographs confirm no progressive signs of healing, the fracture gap is 1 cm or less, the individual can be adequately immobilized, and for pelvic and lower extremity fractures the individual is of an age likely to comply with non-weight bearing. Delayed union, fresh fracture, stress fractures, immediate post-surgical treatment, arthrodesis and failed arthrodesis are listed as investigational applications, and implantable and semi-invasive stimulators are considered investigational.
Get alerts when payers change rules like this one
We check Blue Cross & Blue Shield of Mississippi and other payers every day and email you when a change matches your specialty and state.
01Billing team: Before billing noninvasive stimulator services for a nonunion, confirm the diagnosis meets every criterion above, including serial radiographs showing no progressive healing, because the policy requires ALL of the criteria.
02Billing team: Electrical bone growth stimulators are covered under the Durable Medical Equipment benefit and are subject to any applicable DME co-insurance maximums.
03The covered codes in the source are CPT 20974 (noninvasive) and HCPCS E0747.
04CPT 20975 and HCPCS E0749 (surgically implanted) are listed in the investigational codes table.
05Federal Employee Program: FDA-approved devices may not be considered investigational and may be assessed only on the basis of their medical necessity.
Codes mentioned
20974E0747Q74.0Q74.220975E0749
Original notice
Electrical Bone Growth Stimulation of the Appendicular Skeleton
bcbsms.com · Always check the source before changing claims.
Summaries are AI-assisted. Always confirm against the original payer notice.
What is PolicyChanges
One workspace for payer rules, prior auth, coding and compliance
Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.