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Synthetic Cartilage Implants for Joint Pain

Blue Cross & Blue Shield of Mississippi·Orthopedics, Podiatry·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

BCBS policy A.7.01.160 confirms that synthetic cartilage implants for joint pain, including the FDA-approved Cartiva implant for MTP joint arthritis, remain considered investigational and are not covered. This policy affects billing for procedures using synthetic cartilage replacement materials.

Action Required

Action needed
Billing team must verify that all synthetic cartilage implant procedures are properly coded with the listed investigational codes and ensure claims include appropriate documentation indicating investigational status. Inform providers that these procedures may require patient financial responsibility discussions due to non-coverage status under BCBS plans.

Affected Billing Codes

28291
28899
L8641
L8642
L8699