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Regence BlueShieldAll Plans · Prior Auth · Prior Authorization · OrthopedicsMedium impact

Bone Lengthening (Distraction Osteogenesis)

Effective date
Jan 1, 2027
Identified
Oct 7, 2026

Summary

Bone lengthening (distraction osteogenesis) may be considered medically necessary when the criteria are met. Those criteria require a congenital or post-traumatic limb length discrepancy or an angular deformity of the arm, forearm, thigh or leg, plus one or more listed indications, including fracture nonunion or malunion of a long bone, lengthening of an amputation stump needed for a prosthesis fit, a leg length discrepancy greater than 6 cm, or bone defects with or without deformities. Bone lengthening is considered not medically necessary when these criteria are not met for indications other than short stature, and it is considered cosmetic when done solely to alter short stature. This policy takes effect January 1, 2027.

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What to do

Action · 6 steps
01Effective January 1, 2027: Submit clinical documentation supporting the policy criteria with bone lengthening requests.
02Required documentation includes history and physical or chart notes, and a description of the congenital, trauma, or angular deformity causing the limb length discrepancy, including the amount of discrepancy.
03For fracture nonunion or malunion, include the location, the date of injury or previous fracture treatment, and serial radiographs documenting no progressive signs of healing over the most recent three months.
04For lengthening after amputation, include a description of the length discrepancy and the plan for the post-procedure prosthesis.
05If any of these items are not submitted, it could impact the review and decision outcome.
06For bone lengthening done solely to alter short stature, which is considered cosmetic, providers are encouraged to inform members before the service that they are likely to be financially responsible for the cost.

Codes mentioned

206902069220693206962069724420253912539327458274662771327715

Original notice

Bone Lengthening (Distraction Osteogenesis)
beonbrand.getbynder.com · Always check the source before changing claims.
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Related policy hubs

Regence BlueShield policiesOrthopedicsCode 20690Code 20692Code 20693Code 20696Code 20697Code 24420Code 25391Code 25393Code 27458Code 27466Code 27713Code 27715

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