Bone morphogenetic proteins (bone morphogenic protein, BMP) for lumbar fusion and nonunion fracture of long bones

Recombinant human bone morphogenetic protein (rhBMP) is used as an alternative or adjunct to autologous bone grafts (autografts).

Coverage decision: BMP is covered with conditions for lumbar fusion and nonunion fracture of long bone (Effective date March 1, 2014).

Authorization requirements


Is authorization required?

How do I get pre-authorization?

Yes

L&I (State fund):
- For an inpatient procedure using either BMP-2 or BMP-7, request Utilization Review provided by Qualis
- For an outpatient procedure using BMP-7, complete the Preauthorization Form and fax to (360) 902-4567

Self-insured:
Contact the employer or its third party administrator

 

Billing and payment policies

Related rules and information

 

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