Bone lengthening procedures may be considered medically necessary for correction of congenital or post-traumatic limb length discrepancies;and/or angular deformities of the limb (arm, forearm, thigh or leg) when ANY ONE of the following are met:
- demonstrable non-union or mal-union of long bone with or without bone loss or infection;
- where lengthening of an amputation stump is needed for proper fitting of a prosthesis;
- where leg lengthening is needed to equalize leg length discrepancy greater than 6 cm and for correction of congenital or post-traumatic angular-rotational deformations of the long bones;
- when used for bone defects with or without deformities.
Bone lengthening for conditions other than the above is not medically necessary and, therefore, is not eligible for payment.
Use of a bone-lengthening device for the sole purpose of altering short stature is considered cosmetic; and is therefore, not covered.
Insertion of wires and subsequent osteotomy of the affected limb are performed in the hospital. Removal of the device can be performed in an outpatient setting; thus, hospitalization to remove the bone lengthening device is not medically necessary.
NOTE: Non-union/mal-union is defined as not having united within a minimum of three (3) months of the original trauma.