CommercialCoverageMedium impact
Menaflex (CPB 0786, reviewed 2025-12-02)
Aetna·Orthopedics, Sports Medicine·Medical Policy
We identified it
Aug 17, 2026
Summary
Aetna continues to classify Menaflex (collagen meniscus implant) as experimental, investigational, or unproven for repair and reinforcement of the medial meniscus and all other indications due to insufficient evidence of effectiveness. HCPCS code G0428 and related ICD-10 codes for meniscal injuries are NOT COVERED under this policy. Billing teams must ensure claims for this procedure are not submitted or will face denials.
Action Required
Immediately: Billing team must implement a claims filter to prevent submission of HCPCS code G0428 for Aetna claims. Any Menaflex procedure requests from orthopedic providers must be communicated as non-covered by Aetna. Update billing software to flag G0428 claims with any of the listed ICD-10 codes (M17.x, M22.2x, M23.x, M25.x, M93.2x, S83.2x, S89.9x) as NON-COVERED and UNPAYABLE under Aetna plans. Providers must be notified that claims will be DENIED without exception. Consider requiring patient financial responsibility forms prior to any Menaflex procedure for Aetna beneficiaries. This policy remains in effect as a standing non-coverage determination.