Osteogenesis Stimulator

Coverage

Documentation

Probationary Prior Authorization (PPA) program

The Probationary Prior Authorization (PPA) program provides an additional layer of oversight for newly enrolled DMEPOS suppliers and suppliers that have completed a change of ownership. Under this nationwide program, selected items require prior authorization during a one-year provisional period. Beginning October 15, 2026, two osteogenesis stimulator HCPCS codes will be added.

Probationary Prior Authorization (PPA) HCPCS codes

HCPCS Effective Date Description
E0747 October 15, 2026 OSTEOGENESIS STIMULATOR, ELECTRICAL, NON-INVASIVE, OTHER THAN SPINAL APPLICATIONS
E0748 October 15, 2026 OSTEOGENESIS STIMULATOR, ELECTRICAL, NON-INVASIVE, SPINAL APPLICATIONS

Prior Authorization Timelines

Policy Initial Review Decision Timeframe Expedited Review Decision Timeframe PAR Decision Valid
Osteogenesis Stimulator 5 business days (not to exceed 7 calendar days) 2 business days 60 days

Documentation to Include in PA Package Submission

  • Osteogenesis PA request coversheet
  • Face-to-Face Evaluation (F2F)
  • Written Order Prior to Delivery (WOPD)
    • Must be completed within six (6) months after the required face-to-face encounter
  • Any additional medical records providing support for medical necessity
  • Documentation must be submitted to the appropriate jurisdiction based on the beneficiary's permanent address with the PA coversheet for fax, mail, or electronic submission of medical documentation (esMD). For Noridian Medicare Portal (NMP) submissions, complete all required fields in the portal as a coversheet is not required.

To ensure process efficiency, assure all components are completed and included within the submission.

Tips

KF Modifier

For clams billed with dates of services prior to May 18, 2026, devices coded E0747, E0748, and E0760 are classified by the Food and Drug Administration as Class III devices; therefore, all claims for codes E0747, E0748, and E0760 must include the KF Modifier. For claims billed with dates of service on or after May 18, 2026, devices coded E0747, E0748, and E0760 are reclassified by the Food and Drug Administration as Class II devices; therefore, any claims billed with the KF Modifier on or after May 18, 2026, will be rejected for incorrect billing.

Last Updated Sep 03 , 2026