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Article Detail - JD DME

Osteogenic Stimulation CIM Revision

Original Effective Date: 07/01/2001
Revision Effective Date: 11/01/2013

Coverage Issues Manual (CIM), Section 35-48, Osteogenic Stimulation, has been revised to permit coverage for ultrasonic osteogenic stimulators when there are two sets of radiographs documenting nonunion of a fracture, and the patient has failed at least one surgical intervention for the treatment of the fracture.

This revision to the CIM is a national coverage decision made under §1862(a)(1) of the Social Security Act (the Act). National coverage determinations (NCDs) are binding on all Medicare carriers, fiscal intermediaries, Peer Review Organizations, and other contractors. Under 42 CFR 422.256(b) an NCD that expands coverage is also binding on a Medicare+Choice Organization. In addition, an administrative law judge may not disregard, set aside, or otherwise review a national coverage decision issued under §1862(a)(1) of the Act, (see 42 CFR 405.732 and 405.860).

This policy revision is effective for services provided on or after January 1, 2001. See Chapter 10 of the DMERC Region D Supplier Manual for the complete text of this national policy. Also, refer to the Osteogenesis Stimulators regional medical review policy in Chapter 9 for additional coverage details.

            Last Updated Thu, 11 May 2017 12:55:33 +0000