Intraarticular Knee Injections of Hyaluronan

Intra-articular hyaluronan (viscosupplementation) of the knee is covered when patients have symptomatic knee osteoarthritis with radiologic confirmation, other diagnoses are excluded, and the patient has failed at least 3 months of conservative therapy and, when appropriate, aspiration and intra-articular corticosteroid injection. Repeat series are allowed only after ≥6 months with documented prior benefit (standardized improvement or reduced NSAID/steroid use); treatments outside FDA-labeled dosing/frequency, for non-knee joints, as initial therapy, or during the post-arthroplasty/postoperative period are not covered. Documentation must include symptom and radiologic evidence, failed conservative and steroid therapy records, justification for imaging guidance if used, provider qualifications, and adherence to coding guidance in Article A56157.

"Patient is symptomatic with knee symptoms such as pain interfering with activities of daily living (e."