Miscellaneous Musculoskeletal Procedures - (0515)

Cigna covers ligament allograft materials when medical necessity for the associated primary procedure is documented and limits autologous chondrocyte implantation and osteochondral grafting to the knee (distal femur and patella), while designating many alternative cartilage repair materials/techniques (e.g., TruFit/TruGraft, PolyGraft, DeNovo, Chondrofix), subchondroplasty, in‑office diagnostic arthroscopy, percutaneous ablation, medial knee shock absorbers, thermal shrinkage, and multiple meniscal scaffolds/prostheses as experimental, investigational, or not medically necessary. Key requirements: providers must document medical necessity and use appropriate billing codes, and intra‑articular corticosteroid injections for chronic osteoarthritis are limited to ≤4 injections in a rolling 12‑month period and ≤2 injections on the same day.

"Ligament allograft (e."