DecisionHealth, DecisionHealth - 2025 Issue 8 (August)

Q&A: Look out for payer non-coverage policies for matrix allograft implants

Question: Do you have any guidance on coding for Prochondrix and CartiMax® grafts in the knee? It is our understanding that Prochondrix is an osteochondral allograft so could it perhaps fall under CPT 27415? In research, it appears that the CartiMax may only be cartilage allograft and not osteochondral, which made us feel this might not fall under 27415.

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