Sunday, September 8, 2024

Blue Cross coverage of microprocessor control knees

Dave Janke

http://www.or.regence.com/provider/library/newsletter/docs/bluePrint0504.pdf

Above is a link to the most recent publication from Regence BlueCross of Oregon. On page 4 of 12 of this newsletter you can read about codes
L5846-L5847 (microprocessor control feature) being deemed investigational.

“Clinical treatment considered investigational is not a covered benefit for members enrolled in any traditional, preferred or managed care product unless otherwise noted. Services and supplies that support or are performed in conjunction with the investigational service are also excluded from benefit consideration. Charges denied as investigational are provider write-offs unless the patient agrees in writing prior to receiving services to be financially responsible for the charges.”

FYI,
Dave A. Janke, C.P.O.

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