All PlansCoverageMedium impact
Low Intensity Pulsed Ultrasound Fracture Healing Device
Blue Cross & Blue Shield of Mississippi·MS · Orthopedics, Family Medicine, Internal Medicine +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
This policy establishes medical necessity criteria for Low Intensity Pulsed Ultrasound (LIPUS) fracture healing devices, covering specific fresh fractures in high-risk patients, delayed unions, and nonunions. The devices are covered as durable medical equipment with specific clinical criteria that must be met.
Action Required
Immediately: Billing team must establish protocols for LIPUS device authorization requests. Verify patients meet medical necessity criteria including high-risk factors (diabetes, steroid therapy, osteoporosis, smoking, alcoholism) or specific fracture locations (Jones fracture, scaphoid, metatarsal). Document delayed union (3+ months post-fracture with decelerating healing) or nonunion (6+ months with no progression for 3 consecutive months) with serial radiographs. Process as DME benefit with applicable co-insurance. Claims without proper documentation of risk factors or healing status will be denied.