27428 Insurance Policy Changes

Allograft Transplantation of the Knee - Medicare Advantage (Revised)

Humana Medicare Advantage has updated their policy for allograft knee transplantation procedures, establishing specific medical necessity criteria for meniscal allograft transplantation including age limits (≤50 years), BMI requirements (≤40), and mandatory conservative treatment failure documentation. The policy covers ligament reconstruction with allografts and sets clear coverage limitations for certain implant types.