Guides / E0747
E0747 Electrical osteogenesis stimulator — non-spinal (E0747) and spinal (E0748)Medicare Osteogenesis Stimulator Documentation Requirements (E0747, E0748)
Citations verified against the CMS Medicare Coverage Database · Reviewed September 2026
Bone growth stimulators are purchased, expensive, and reviewed on a narrow set of clinical facts: for a non-spinal stimulator, that a fracture has objectively stopped healing; for a spinal one, what kind of fusion the beneficiary had and when. LCD L33796 spells out both, including exactly how a nonunion has to be proven.
CMS suspended the prior-authorization requirement for E0747, E0748 and E0760 in August 2024, so they are not on the Required PA List. They are, however, two of the forty codes on the new Probationary Prior Authorization list, which applies to newly enrolled suppliers from October 15, 2026. Below is the requirement set AffirmDME checks on these cases.
The requirements, with citations
Every item below is a check AffirmDME runs automatically — this list mirrors the production rules engine, not a paraphrase of the regulations.
E0747: a qualifying non-spinal condition
One of: nonunion of a long-bone fracture with radiographic evidence that healing has ceased for three or more months; a failed fusion of a non-spinal joint at least nine months after the last surgery; or congenital pseudarthrosis.
LCD L33796 — E0747 coverage criteriaE0747 nonunion: two radiograph sets at least 90 days apart
Both sets must predate the stimulator, include multiple views of the fracture site, and carry the treating practitioner's written interpretation that there was no clinically significant healing between them.
LCD L33796 — nonunion radiographic documentationE0748: a qualifying spinal indication
One of: a failed spinal fusion at least nine months after the last surgery; a multilevel fusion (three or more vertebrae); or a fusion at a site with a previously failed fusion.
LCD L33796 — E0748 coverage criteriaFracture or surgical history with dates
Chart notes must give the injury or surgery dates and, for spinal cases, the levels fused — the nine-month and multilevel tests are computed from them.
Policy Article A52513 — osteogenesis stimulator documentationDiagnosis codes present
ICD-10 codes on the claim must match the documented nonunion, fusion, or pseudarthrosis.
Policy Article A52513 — diagnosis codingStandard Written Order (SWO) on file
A complete written order must exist before the claim is submitted — patient name, item description, quantity, ordering practitioner, and signature.
42 CFR 410.38(d)Order date and practitioner signature
The SWO must be dated and signed by the treating practitioner. Undated or unsigned orders are treated as no order at all.
42 CFR 410.38(d)Practitioner NPI on the order
The ordering practitioner's NPI must appear on the order and match PECOS enrollment.
42 CFR 410.38(d)Face-to-face encounter documented
Chart notes must document an in-person (or permitted telehealth) encounter where the practitioner evaluated the patient for the item.
42 CFR 410.38(d)(2)Face-to-face within 6 months of the order
The qualifying encounter must have occurred within the 6 months before the order date.
42 CFR 410.38(d)(2)Medical necessity in the clinical record
The medical record — not just the order — must support why the item is medically necessary for this patient.
CMS PA Documentation ChecklistLength of need documented for rental items
Since the 2020 SWO rule, length of need is no longer a required element of the order itself — but the DME MAC PA portals ask for it, and the record must support the expected duration of use. AffirmDME requires an estimated length of need (1–99 months; 99 = lifetime) on every capped-rental item so the packet never stalls on it.
42 CFR 410.38(d) — SWO elements (2020 rule); DME MAC PA request fieldsWhat usually sinks these claims
- Only one set of radiographs, or two sets fewer than 90 days apart
- Radiology reports without the treating practitioner's written statement that healing has not progressed
- A delayed union or fresh fracture billed as nonunion
- Spinal cases where the operative report is missing, so the levels fused and the surgery date cannot be verified
- KX billed when a criterion was not met
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Check a case freeFAQ
Does Medicare require prior authorization for bone growth stimulators?
Not on the Required PA List — CMS suspended the requirement for E0747, E0748 and E0760 effective August 28, 2024. Newly enrolled DMEPOS suppliers are the exception: E0747 and E0748 are on the Probationary Prior Authorization list that starts October 15, 2026, for a supplier's first year.
How does Medicare define nonunion for E0747?
Radiographic evidence that fracture healing has ceased for three or more months before treatment starts, shown by two sets of radiographs at least 90 days apart, each with multiple views and a treating practitioner's written interpretation of no clinically significant healing between them.
Which bones count as long bones?
The LCD lists the clavicle, humerus, radius, ulna, femur, tibia, fibula, metacarpals, and metatarsals.
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This guide summarizes Medicare requirements as implemented in AffirmDME's compliance engine, with citations to the governing sources. It is not legal or billing advice; LCDs and CMS policy change — always confirm against the current policy text linked above.
Also drawn on: Noridian — CMS suspends prior authorization for osteogenesis stimulators (2024) .
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- The Medicare DMEPOS Required Prior Authorization List, explained (2026)
- Probationary Prior Authorization for newly enrolled DMEPOS suppliers (Oct 15, 2026)
- The DMEPOS prior authorization exemption: how it works and how to keep it
- Which DME MAC handles your claim: Jurisdictions A, B, C, and D
- Standard Written Order (SWO) requirements for Medicare DME
- Medicare DME face-to-face encounter requirements
- Prior authorization vs ADR vs prepayment review vs TPE: what each means for a DME claim
- After a non-affirmed prior authorization: resubmit, deliver with an ABN, or wait
- Medicare DME proof of delivery requirements
- Preparing and submitting a DMEPOS prior authorization request
Unfamiliar term? The glossary defines ADR, SWO, UTN, PTAN and the rest; the PA List lookup checks any HCPCS code.