Medical Policy Update: Recombinant and Autologous Platelet-Derived Growth Factors as a Treatment of Wound Healing and Other Non-Orthopedic Conditions

Effective November 27, 2017, the guidelines of our medical policy, Orthopedic Applications of Platelet-Rich Plasma, will be applied to claims for services provided to patients enrolled in Horizon Blue Cross Blue Shield of New Jersey Medicare Advantage (MA) plans.

The guidelines of this policy identify that the use of platelet-rich plasma in patients with musculoskeletal conditions and those undergoing orthopedic surgical procedures is considered an experimental or investigational service.

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

Based on the guidelines of our medical policy, Orthopedic Applications of Platelet-Rich Plasma, HCPCS codes 0232T and/or P9020 submitted on claims for services provided on and after November 27, 2017 to members enrolled in Horizon BCBSNJ MA plans will be denied as experimental/investigational services regardless of the submitted diagnosis code(s).

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 on and after November 27, 2017.