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Advocacy Action Center: BCBS of Michigan: Hyaluronan Injections No Longer Payable (Effective 4/1/18)

Mar 06, 2018

*This message was sent on behalf of your Michigan Academy of Physical Medicine & Rehabilitation*

Michigan Academy of Physical Medicine & Rehabilitation
Steven Arbit, M.D., President
8391 Commerce Road
Suite 107
Commerce Twp, MI 48382
mapmr@icloud.com

Hello Michigan Physiatrists,
 
The Michigan Academy of PMR has been revived. There is an issue that has come to the forefront that we need to take action on. 
 
Blue Cross Blue Shield of Michigan recently released their guidelines on the use of Hyaluronan injections in the knee. Based on these guidelines, BCBS of Michigan has determined that "the use of intra-articular injections of Hyaluronans is considered not medically necessary for osteoarthritis of the knee and all other knee conditions. "
 
Effective April 1, 2018, Hyaluronan injections will no longer be payable. These include: J7320, J7321, J7322, J7323, J7324, J7325, J7326, J7327 and J7328. This is based on a medical policy decision to change the status of the procedure code to experimental and no longer payable.
 
Attached is a sample letter you can copy and paste on your letterhead and send to BCBSM to argue their decision. The letters should be mailed or emailed to Dr. Thomas Simmer, Sr. VP and Chief Medical Officer at tsimmer@bcbsm.com.
 
Thomas Simmer MD
Senior VP and Chief Medical Officer
500 Renaissance Dr. Tower 500
11th floor
Detroit, MI 48243
 
Thank you for your attention to this matter.
 
Sincerely,
Steven Arbit, M.D


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