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***

CMF Script

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 bonestim@optimasurgical.com


3.  Upload required documentation online with the File Upload Tool  

Please remember that medical information provided by Optima Surgical in the absence of a visit with a health care professional, must be considered as an educational service only. The information sent through e-mail should not be relied upon as a medical consultation. This mechanism is not designed to replace a physician's independent judgement about the appropriateness or risks of a procedure for a given patient. We will do our best to provide you with information that will help you make your own health care decisions.


Many external links have been provided on this site as a service and convenience to our patients and other visitors to our website. These external sites are created and maintained by other public and private organizations. We do not control or guarantee the accuracy, relevance, timeliness, or completeness of this outside information.



TEMPE, AZ 85282



  • LinkedIn - White Circle
  • Instagram - White Circle
  • Facebook - White Circle
  • Twitter - White Circle

© 2015 by Optima Surgical

All Rights Reserved