Bone Morphogenetic Protein
SUR705.038
This policy covers use of recombinant human bone morphogenetic proteins (primarily rhBMP‑2/INFUSE) as an adjunct or alternative to autologous iliac crest bone graft in skeletally mature patients for specified indications such as anterior lumbar interbody and other instrumented spinal fusions, long‑bone nonunion, treatment of certain acute open tibial shaft fractures (INFUSE applied within 14 days with intramedullary nail fixation), and select bone defect or maxillofacial reconstructions. Coverage is limited to cases when autograft is not feasible or sufficient, is experimental/investigational for all unlisted indications, is not FDA‑approved for cervical spine use (risk of life‑threatening airway/neurologic compromise), and rhBMP‑7 (OP‑1) is not available in the U.S.
"Use of recombinant human bone morphogenetic protein-2 (rhBMP-2; Infuse™) may be considered medically necessary in skeletally mature individuals."