SURG.00162 Implantable Shock Absorber for Treatment of Knee Osteoarthritis

This policy addresses implantable shock absorber devices for knee osteoarthritis, such as the MISHA Knee System. Anthem deems these devices investigational and not medically necessary; therefore, they are not covered for any indication, including after failure of non-surgical or surgical treatments. Noncoverage applies to all implantable knee shock absorber devices and related services/supplies, with no exceptions noted.

"Use of an implantable shock absorber device for treatment of osteoarthritis of the knee is consideredinvestigational and not medically necessary."

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