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Orthopedic Applications of Stem-Cell Therapy

Section: Surgery
Effective Date: September 01, 2019
Revised Date: August 02, 2019
Last Reviewed: July 16, 2019

Description

Mesenchymal stem cells (MSCs) are multipotent cells (also called stromal multipotent cells) that can differentiate into various tissues including organs, trabecular bone, tendon, articular cartilage, ligaments, muscle, and fat. MSCs are associated with the blood vessels within bone marrow, synovium, fat, and muscle, where they can be mobilized for endogenous repair as occurs with healing of bone fractures. Stimulation of endogenous MSCs is the basis of procedures such as bone marrow stimulation (e.g., microfracture) and harvesting/grafting of autologous bone for fusion.

Criteria

The following orthopedic applications are considered experimental investigational and therefore non-covered. Scientific evidence does not support the use of these procedures in the peer-reviewed literature.

  • Mesenchymal stem cell therapy (including but not limited to Regenexx Procedure) is considered experimental/investigational and therefore non-covered for all orthopedic applications, including use in repair or regeneration of musculoskeletal tissue.
  • Allograft bone products containing viable stem cells, including but not limited to demineralized bone matrix (DBM) with stem cells are considered experimental/investigational for all orthopedic applications and therefore non-covered.
  • Allograft or synthetic bone graft substitutes that must be combined with autologous blood or bone marrow are considered experimental/investigational and therefore non-covered for all orthopedic applications.

Procedure Codes

20932 20933 20934 38206 38230 38232 38241

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