Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound

Amniotic- and placental-derived product injections or applications (from any combination of amnion, chorion, placenta, Wharton's jelly, umbilical cord/blood, or amniotic fluid, in any processed form) are non-covered for all musculoskeletal indications including joint pain, back pain, tendon/ligament injuries, cartilage damage, osteoarthritis, and as adjuncts in orthopedic surgery due to lack of standardization and insufficient evidence. This LCD does not address burns, wounds, or ophthalmic conditions, and stem cell transplantation is governed separately by CMS NCD §110.23.

"All injections or applications of amniotic membrane, amniotic fluid, or any other placental-derived products for managing musculoskeletal injuries, joint conditions, back pain, chronic pain, tendon..."

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