Intended for U.S. health care professionals only
Dedicated Support Tailored to Your Patients
A dedicated MyCartilageCare Case Manager is committed to offering comprehensive support tailored to your patient’s individual insurance requirements and treatment goals. Call 1-877-872-4643 or email [email protected].
MyCartilageCare offers support including:
Insurance
support
Treatment
education
Biopsy
storage
Patient insurance approval
MyCartilageCare can provide patient benefit investigation, predetermination & prior authorization, and reimbursement support.
MACI insurance approval success rates*
89% of all MACI cases were approved on initial submission
5% Not appealed
5% Approved on appeal
1% Denied after appeal
MACI insurance approval specific to patella cases
- 89% Approved on initial submission
- 5% Approved on appeal
- 5% Not appealed
- 1% Denied after appeal
MACI cases activated between January 2021 and December 2021. Data on file. Insurance approval is defined as payor pre-authorization for the MACI procedure. Nothing contained herein is intended, nor should it be construed, to suggest a guarantee of coverage or reimbursement for any product or service. Check with the individual insurance provider regarding coverage.
Billing Codes
CPT Code:
27412
Autologous chondrocyte implantations, knee
HCPCS Code:
J7330
Autologous cultured chondrocytes, implant
Biopsy HCPCS Code:
S2112
Arthroscopy, knee, surgical for harvesting of cartilage (chondrocyte cells)
Item 21 or Form Locator (FL) 67—Diagnosis Code: The appropriate ICD-10-CM code(s) should be entered for the MACI implant in Item 21 of the CMS-1500 form for physician offices or FL 67 of the CMS-1450 (UB-04) claim form for the hospital outpatient department.
The content presented is for informational purposes only and is not a guarantee of coverage. Providers should exercise independent clinical judgment when selecting codes and submitting claims to reflect accurately the services rendered to individual patients. Providers are responsible for selecting coding options that most accurately reflect a patient’s condition, the provider’s system guidelines, payer requirements and services rendered.
Important notes for physician offices: Reimbursement will depend upon the contract with the insurer. The physician may want to consult with the insurer’s contracting representative to determine how the contract may affect reimbursement.
Upcoming events
April 12, 19, & 26, 2023
Work of ART Programs (3): ARThroscopy, ARThrotomy, ARTicular Cartilage + Osteotomy
Virtual—Hosted by Biologics Association
May 3, 2023
Biologic Association Summit
New Orleans, LA
May 4-6, 2023
Arthroscopy Association of North American Annual Meeting (AANA)
New Orleans, LA
June, 2023
Fellows "Advanced" Course
Virtual
July 13-16, 2023
AOSSM Annual Meeting
Washington DC
July 28-29, 2023
AOSSM Fellows Course
OLC Rosemont, IL
August 4-6, 2023
AANA/SOMOS Military Knee Course
OLC Rosemont, IL
August 21-25, 2023
PA Ortho Society Meeting
Indianapolis, IN
September 9-12, 2023
International Cartilage Repair Society (ICRS) World Congress
Barcelona, Spain
September 22-24, 2023
AAOS Surgical Skills in Total Hip and Total Knee Arthroplasty
OLC Rosemont, IL
October, 2023
Fellows "Basics" Course
Virtual
October 6-7, 2023
AOSSM/ISAKOS Surgical Skills Course – Knee Osteotomy
OLC Rosemont, IL
November, 2023
WebinHER
Virtual
November, 2023
AOSSM/FORUM Surgical Skills Course
OLC Rosemont, IL
November, 2023
MACI National Advanced Surgical Technique Lab
November, 2023
MASTERs (MACI Advanced Surgeon Training)
Virtual
December 14-16, 2023
AANA Foundations in Arthroscopy (Knee and Shoulder for Residents)
OLC Rosemont, IL
MACI surgeon training
Ready to introduce MACI to your patients with knee cartilage injuries? Complete surgeon training at:
MACI physical therapist training
Ready to become a MACI cartilage repair physical therapy expert? Expand your rehab expertise by completing MACI PT training at:
Do you have patients interested in talking with real MACI patients about their experience?
The MACI Mentor Program gives patients considering MACI an opportunity to connect one-on-one with real MACI patients by phone.
Encourage your patients to speak with a MACI Mentor at 1-888-237-5493 or visit MACImentors.com