CommercialAdministrativeLow impact
11.14.06j, Autologous Chondrocyte Implantation (ACI) and Other Cell-based Treatments of Focal Articular Cartilage Lesions (Independence Administrators)
Independence Blue Cross·Orthopedics, Sports Medicine·Medical Policy
We identified it
Jun 19, 2026
Summary
This is a routine reissue of Independence Administrators' ACI/MACI policy with no substantive changes to coverage criteria, medical necessity requirements, or billing codes. The policy continues to cover autologous chondrocyte implantation and MACI for symptomatic full-thickness knee cartilage defects meeting specific criteria, and remains applicable only to Independence Administrators members whose groups have not enrolled in the UM vendor program. Commercial Independence members must use AIM Specialty Health guidelines instead.
Action Required
No immediate action required. This is a routine policy reissue confirming the Company's continuing position on ACI and MACI with no changes to coverage criteria, billing codes, or requirements. Verify that your billing system applies this policy only to Independence Administrators claims for groups NOT enrolled in the UM vendor program. For Commercial Independence members, confirm that claims are being evaluated under AIM Specialty Health Guidelines per policy 00.01.66 instead. No workflow changes are necessary at this time.