Ordering an External Bone Growth Stimulator
Follow the instructions below to order...
Patients that Qualify:
1. Failed fusion, where a minimum of 9 months has elapsed since the last surgery;
2. Previous fusion at same level
3. Multiple level fusion - A multiple level fusion involves 3 or more vertebrae (e.g., L4-S1)
***Medicare Patients are allowed one (1) bone growth stimulator in a five (5) year period***
Required Documentation to Authorize:
1. Script that includes Provider NPI, Date, & Signature. A practice script can be used or the CMF script below.
2. Patient Demographics that includes demographics and insurance information.
3. Chart Notes/Op Report including ICD-10, Surgery Date, Physician Signature. Under treatment plan please dictate...
“Ordering spinal bone growth stimulator for assistance with the healing process given________________. ie: the patient risk factors, multi-level fusion, failed fusion, or repeat single level fusion”.
Options to Submit Order:
1. Fax required documentation to 602-391-2622
2. Email required documentation to
3. Upload required documentation online with the File Upload Tool