Electromagnetic therapy is covered for the management of the following types of chronic ulcers when it is used as adjunctive therapy after there are no measurable signs of healing for at least 30 days of treatment with conventional wound treatments (Electromagnetic therapy will not be covered as an initial treatment modality.):
- Arterial ulcers
- Diabetic ulcers
- Pressure ulcers (Stage III or Stage IV)
- Venous stasis ulcers
Continued treatment is not covered if measurable signs of healing have not been demonstrated within any 30-day period of treatment. Measurable signs of improved healing include a decrease in wound size either in surface area or volume, decrease in amount of exudates, and decrease in amount of necrotic tissue. If electromagnetic therapy is being used, wounds must be evaluated at least monthly by the treating physician.
All other uses of electromagnetic therapy for the treatment of chronic ulcers will be denied as not medically necessary and, therefore, not covered.
Electromagnetic therapy for wound healing is not covered in the home setting, as unsupervised use by individuals in the home has not been found to be medically necessary. Therefore, payment will not be made for an electromagnetic wound treatment device used to treat wounds.
Electrical stimulation or electromagnetic therapy services that do not meet the medical necessity criteria on this policy will be considered not medically necessary.
It would not be appropriate for a individual to receive both electrical stimulation and electromagnetic therapy for the treatment of these wounds.