CommercialAdministrativeLow impact
11.14.03h, Meniscal Allograft Transplantation and Meniscal Implants (Independence Administrators)
Independence Blue Cross·Orthopedics, Sports Medicine·Medical Policy
We identified it
Jun 19, 2026
Summary
This is a routine annual reissue of Independence Administrators' meniscal allograft transplantation policy with no substantive changes to coverage criteria, medical necessity requirements, or billing codes. The policy continues to cover meniscal allograft transplantation (CPT 29868) when specific clinical criteria are met, and maintains experimental/investigational status for collagen meniscus implants (HCPCS G0428). No immediate billing workflow changes are required.
Action Required
No immediate action required. This is a reissue with no changes to the policy. Billing teams should verify that their current systems reflect the existing coverage rules: CPT 29868 requires prior authorization and documentation of medical necessity criteria (patient age, prior meniscectomy, refractory knee pain, stable knee joint, minimal cartilage degeneration per Outerbridge Grade II or less). HCPCS G0428 (collagen meniscus implants) remains non-covered as experimental/investigational. If your practice has not previously implemented these rules, establish them now. For Independence Administrators claims only, confirm that patient groups have not enrolled in the UM vendor program, as this policy does not apply to those groups after their renewal date.