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05.00.81a, Osteogenic Stimulators (non-invasive, invasive/semi-invasive, electrical and ultrasound)
Effective date
Sep 23, 2024
Identified
Jun 19, 2026
Summary
Independence Blue Cross reissued policy 05.00.81a on osteogenic stimulators with minor updates effective 09/23/2024. Key changes include: addition of HCPCS code A4558 (conductive gel/paste) as medically necessary, deletion of modifiers EY and KF, revised refill timelines, and expanded coverage for noninvasive electrical bone growth stimulators of the lumbar spine (E0748) for members under Independence Administrators claims administration without UM vendor enrollment.
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What to do
Action · 7 steps
01REQUIREMENTS:
- By 09/23/2024 (already effective): Billing team must update billing system to add HCPCS code A4558 (conductive gel or paste for electrical devices) as a medically necessary supply code and ensure it can be billed alongside osteogenic stimulator codes (E0747, E0748, E0749, E0760, CPT 20974, 20975, 20979).
02- Immediately: Remove modifiers EY (No physician or other health care provider order) and KF (FDA Class III Device) from all osteogenic stimulator claims in the billing system.
03- Before next claim submission: Update authorization and billing rules to recognize E0748 (Osteogenesis stimulator, electrical, noninvasive, spinal applications) as medically necessary for lumbar spine applications when member is under Independence Administrators claims administration and group has not enrolled in UM vendor program.
04Verify member eligibility parameters in system.
05- Immediately: Review and update refill requirement timelines in billing system per revised policy (specific timeline changes not detailed in source material—obtain complete policy document from Independence Blue Cross).
06- Ongoing: Ensure all claims include required documentation: timely provider orders (signed and dated before claim submission, not retrospective), proof of delivery with member signature/caregiver receipt, and serial radiographs (if applicable per medical necessity criteria).
07- Consequences: Claims submitted without updated codes, with deleted modifiers, or lacking required documentation will be denied by Independence Blue Cross.
Codes mentioned
209742097520979E0747E0748E0749E0760A4558A4559
Original notice
05.00.81a, Osteogenic Stimulators (non-invasive, invasive/semi-invasive, electrical and ultrasound)
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 PolicyMA05.018d, Non-Spinal Osteogenic Stimulators (Electrical and Ultrasonic)MediumEffective Sep 9, 2024 · Medical PolicyMA05.006l, Transcutaneous Electrical Nerve Stimulators (TENS) and Associated SuppliesMediumEffective Dec 29, 2025 · Medical PolicyBrowse every Independence Blue Cross change in the policy list