20604 Insurance Policy Changes

Viscosupplementation (CPB 0179, reviewed 2026-09-02)

This is a historical medical policy document (CPB 0179) for viscosupplementation (hyaluronate injections) for knee osteoarthritis, newly discovered on 2026-10-06 but last reviewed 2026-09-02. The policy establishes medical necessity criteria for initial approval and continuation of therapy, specifies covered/non-covered CPT codes, and identifies experimental indications. No effective date change is stated in the source; billing teams should verify current applicability with Aetna directly.