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MA05.018d, Non-Spinal Osteogenic Stimulators (Electrical and Ultrasonic)
Effective date
Sep 9, 2024
Identified
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage policy MA05.018d has been reissued with minor updates effective 09/09/2024. Key changes include: (1) Policy title updated to emphasize Non-Spinal applications; (2) Face-to-face requirement language added for HCPCS codes E0747 and E0760 per 2024 CMS rules; (3) HCPCS code A4558 (conductive gel/paste) added as medically necessary; (4) Modifiers EY and KF deleted; (5) Refill requirement timelines revised. Coverage criteria for electrical and ultrasonic bone growth stimulators remain aligned with Medicare guidelines.
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What to do
Action · 7 steps
01By 09/09/2024 (already effective).
02Billing team must update billing system to enforce face-to-face encounter documentation requirement prior to claim submission for HCPCS codes E0747 (noninvasive electrical stimulator) and E0760 (ultrasonic stimulator).
03Add A4558 (conductive gel/paste) to medically necessary supply codes in billing system—verify this code is being billed alongside E0747 claims when applicable.
04Remove modifiers EY and KF from any system rules or templates for osteogenic stimulator claims.
05Review and update refill requirement timelines in billing system for both electrical and ultrasonic devices to align with revised policy language.
06Providers must document face-to-face encounter on patient record before billing E0747 or E0760.
07Update encounter templates and superbills to prompt providers for face-to-face documentation.
If missed: Failure to obtain and document face-to-face encounters will result in claim denials for E0747 and E0760.
Codes mentioned
209742097520979E0747E0749E0760A4558A4559
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 →MA05.018d, 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 Policy05.00.81a, Osteogenic Stimulators (non-invasive, invasive/semi-invasive, electrical and ultrasound)MediumEffective Sep 23, 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