← Back to list
MA05.018d, Non-Spinal Osteogenic Stimulators (Electrical and Ultrasonic)
Act
by Sep 9, 2024
Effective date
Sep 9, 2024
Identified
Sep 3, 2026
Summary
Independence Blue Cross updated MA05.018d to clarify coverage for non-spinal osteogenic stimulators (electrical and ultrasonic). Key changes include: (1) added face-to-face requirement language for HCPCS codes E0747 and E0760 per 2024 CMS rules, (2) revised refill timelines, (3) added HCPCS code A4558 (conductive gel) as medically necessary, and (4) deleted modifiers EY and KF from policy requirements. The policy explicitly excludes spinal applications, which are managed separately through Carelon.
Get alerts when payers change rules like this one
We check Independence Blue Cross and other payers every day and email you when a change matches your specialty and state.
Get Independence Blue Cross alertsPolicy Monitoring is free. No card required.
What to do
by Sep 9, 2024 · 8 steps
01Billing team must ensure claim submission systems require face-to-face documentation for HCPCS codes E0747 (noninvasive electrical stimulator) and E0760 (ultrasonic stimulator) per 2024 CMS Final Rule.
02Update prior authorization templates and claim validation rules.
03Add HCPCS code A4558 (conductive gel/paste) to the medically necessary supply list for electrical bone growth stimulator claims.
04Remove modifiers EY (no provider order) and KF (FDA Class III Device) from all claim submissions for these codes—claims submitted with these modifiers will be denied.
05Update refill authorization timelines in the billing system per policy guidance (specific timeline not detailed in summary).
06Providers and clinical staff must document face-to-face encounters for E0747 and E0760 on all claims.
07Failure to include face-to-face documentation will result in claim denials.
08Coordinate with Carelon Medical Benefits Management for any spinal fusion cases, as those fall outside this policy.
Codes mentioned
20974209752097920999E0747E0749E0760E1399A4558A4559
Original notice
MA05.018d, Non-Spinal Osteogenic Stimulators (Electrical and Ultrasonic)
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →05.00.81a, Osteogenic Stimulators (non-invasive, invasive/semi-invasive, electrical and ultrasound)MediumEffective Sep 23, 2024 · Medical PolicyMA05.018d, Non-Spinal Osteogenic Stimulators (Electrical and Ultrasonic)MediumEffective Sep 9, 2024 · Medical Policy05.00.81a, Osteogenic Stimulators (non-invasive, invasive/semi-invasive, electrical and ultrasound)MediumEffective Sep 23, 2024 · Medical PolicyMA00.005as, Experimental/Investigational ServicesHighEffective Apr 1, 2026 · Medical PolicyBrowse every Independence Blue Cross change in the policy list