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Medical Policy Revision: Arthroscopic Debridement and Lavage as Treatment for Osteoarthritis of the Knee

Effective September 5, 2016, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain claims for arthroscopic debridement and lavage of the knee.

The guidelines of our revised medical policy, Arthroscopic Debridement and Lavage as Treatment for Osteoarthritis of the Knee, identify if the arthroscopic debridement and lavage of the knee is considered a medically necessary service.

We encourage you to review this policy in our Medical Policy Manual.

Based on the guidelines of our medical policy, Arthroscopic Debridement and Lavage as Treatment for Osteoarthritis of the Knee, AND the submitted diagnosis code(s):

  • For members enrolled in Horizon BCBSNJ Medicare Advantage plans:
    CPT® codes 29871 and/or 29874 included on claims for services provided on and after September 5, 2016 may be denied as not medically necessary.
  • For members enrolled in plans other than Horizon BCBSNJ Medicare Advantage plans:
    CPT codes 29871, 29874 and/or 29877 included on claims for services provided on and after September 5, 2016 may be denied as not medically necessary.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service on and after September 5, 2016.

CPT® is a registered mark of the American Medical Association.

Published on: June 7, 2016, 09:36 a.m. ET
Last updated on: November 25, 2020, 00:24 a.m. ET