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Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions

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

Summary

This policy establishes coverage criteria for autografts and allografts used to treat focal articular cartilage lesions, primarily affecting knee, ankle, and other joint procedures. The policy outlines various treatment options including osteochondral grafts, minced cartilage procedures, and microfracture techniques, providing guidance on when these procedures are appropriate.

Action Required

Action needed
Review current billing practices for cartilage repair procedures to ensure alignment with new policy guidelines. Billing team should verify that documentation supports medical necessity for osteochondral autografts, allografts, and related cartilage repair procedures. Ensure proper coding and documentation requirements are met for procedures involving systems like Mosaicplasty, OATS, BioCartilage, DeNovo NT, and Chondrofix products.

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