CommercialCoverageHigh impact
Bone Growth Stimulators 1.01.53
Excellus BlueCross BlueShield·Orthopedics, Neurosurgery, General Surgery·Bone & Joints (Orthopedic)
Effective date
Apr 16, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their bone growth stimulator policy effective April 16, 2026, establishing specific medical necessity criteria for electrical and ultrasonic bone growth stimulators. The policy defines when these devices are medically appropriate versus investigational, and includes guidelines for repairs and replacements.
Action Required
By April 16, 2026: Billing team must update prior authorization processes to align with new medical necessity criteria for bone growth stimulators. Review all pending and future bone growth stimulator claims to ensure they meet the specific criteria outlined (e.g., 3+ months elapsed since injury, documented non-union with serial radiographs 90+ days apart, fracture gap ≤1cm). Update encounter forms and EMR templates to capture required documentation elements. Claims not meeting these criteria will likely be denied as investigational or not medically necessary.