Stem Cell Therapy for Orthopaedic Applications - (0552)

Cigna deems mesenchymal/stem cell therapy for orthopaedic and musculoskeletal uses (including regeneration/repair of ligaments/tendons/meniscus/muscle, joint disease/articular cartilage repair, osteoarthritis, fracture/nonunion repair, osteonecrosis, and specified rotator cuff procedures) not medically necessary and therefore excluded — specific CPT/HCPCS codes designated as not medically necessary include 20999, 38230, 38232, 0565T, 0566T, 0717T, 0718T, and P9099. Claims must be billed with the appropriate, covered diagnosis/procedure codes (using the most appropriate codes as of the submission date) or they will be denied, and final coverage/reimbursement depends on the member’s specific benefit plan and required clinical documentation.

"regeneration and/or repair of musculoskeletal tissue (e."

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