Chondral Injuries Of the Knee A Contemporary View of Cartilage Restoration Brian J. Cole, MD, MBA Assistant Professor of Sports Medicine Medical Director. N Diagnosis and Symptoms. Diagnosis can be established on the basis of an accurate history and a thorough physical examination. Assessment of the progression of edema. CME, MOC and Meetings. Earn your CME from the convenience of your home or office by accessing ACGs webbased educational programs, or attend one of ACGs regional or. Medicare Billing Guidelines, Medicare payment and reimbursment, Medicare codes. Original Research Hypergranulation tissue evolution, control and potential elimination Wound Healing Southern Africa 2010 Volume 3 No 2 exudate management. RootCanal-Treatment.jpg&w=960&h=960' alt='Soft Tissue Debridement Definition' title='Soft Tissue Debridement Definition' />Bone and Tendon Graft Substitutes and Adjuncts. Number 0. 41. 1Policy. INFUSE Bone Graft Bone Morphogenic Protein 2. Aetna considers the INFUSE Bone Graft medically necessary for lumbar spinal fusion procedures in skeletally mature persons who meet the following criteria The member meets medical necessity criteria for lumbar spinal fusion in CPB 7. Spinal Surgery Laminectomy and Fusion and. Use of autograft is unfeasible for any of the following reasons. Member has received a previous autograft and is not a candidate for further autograft procedures because the tissue is no longer available or. There is insufficient autogenous tissue for the intended purpose or. Member is deemed an unacceptable candidate for autograft for any of the following reasons Advanced age over 6. Excessive risk of anatomic disruption including fracture from harvesting autograft from donor site or. Member has concurrent medical conditions and co morbidities e. Members bone is of poor quality osteoporosis or. Obesity or. Presence of morbidity infection, or fracture preventing harvesting at autograft donor site and. INFUSE Bone Graft is to be used with a cage for example, the Medtronic. Titanium Threaded Interbody Fusion Device, the LT CAGE Lumbar Tapered Fusion Device, or the INTER FIX or INTER FIX RP Threaded Fusion Device and. INFUSE Bone Graft and device is to be implanted via an anterior approach. The INFUSE Bone Graft is considered medically necessary for treating skeletally mature persons with acute, open tibial shaft fractures that have been stabilized with intramedullary nail fixation after appropriate wound management, when INFUSE Bone Graft is applied within 1. Aetna considers the INFUSE Bone Graft experimental and investigational for all other indications, including its use in ankle fusion, cervical fusions, and multiple levels because its effectiveness for indications other than the ones listed above has not been established. Note The INFUSE Bone Graft is also known as bone morphogenic, or morphogenetic protein 2, BMP 2. Pro Osteon Porous Hydroxyapatite Bone Graft Substitute. Aetna considers the Pro Osteon Porous Hydroxyapatite Bone Graft Substitute experimental and investigational for repair of metaphyseal fracture defects or repair of long bone cyst and tumor defects, because it has not been shown to be more effective than autograft or cadaveric allograft for these indications. Aetna considers the Pro Osteon Bone Graft Substitute experimental and investigational for use in spinal fusion, epiphyseal fractures or other indications because its effectiveness for these indications has not been established. Blausen_0774_RootCanal-768x768.png' alt='Soft Tissue Debridement Definition' title='Soft Tissue Debridement Definition' />Platelet Rich Plasma. Aetna considers the use of platelet rich plasma, alone or in conjunction with bone grafting materials, experimental and investigational for augmentation procedures e. See also CPB 0. 24. Wound Care stating that autologous platelet rich plasma, autologous platelet gel, and autologous platelet derived growth factors e. Procuren are considered experimental and investigational for chronic wound healing. Porcine Intestinal Submucosa Surgical Mesh. Soft Tissue Debridement Definition' title='Soft Tissue Debridement Definition' />Aetna considers a surgical mesh composed of porcine intestinal submucosa experimental and investigational because its clinical value in rotator cuff repair surgery, repair of anorectal fistula, and for other indications has not been established. Allograft for Spinal Fusion. Football Game Day Snacks. Aetna considers cadaveric allograft and demineralized bone matrix e. Accell, Allo. Fuse, Allogor DBM, Allomatrix, DBX, Dyna. Graft, Dyna. Graft, Exactech Resorbable Bone Paste, Grafton DBM, Intergro DBM, Magnifuse, Optefil, Opteform, Origen DBM, Ortho. Blast, Ostefil, Osteo. Select, Osteo. Sponge, and Progenix medically necessary for spinal fusions. Allograft materials that are 1. The Clinical Problem. Cellulitis is an acute, spreading pyogenic inflammation of the dermis and subcutaneous tissue, usually complicating a wound, ulcer, or dermatosis. BONES AND SOFT TISSUES Ed Friedlander, M. D., Pathologist scalpelbladeyahoo. No texting or chat messages, please. Ordinary emails are welcome. Bone Void Fillers for Nonunions. Aetna considers bone void fillers experimental and investigational for the treatment of delayed unions and nonunions and for use in spinal fusions because they have not been proven effective for these indications. Note Bone void fillers e. Allomatrix putty, Integra Mozaik Osteoconductive Scaffold putty, Opteform, a demineralized bone matrix based allograft, and Vitoss bioactive bone graft are most commonly used in orthopedic surgery for filling osteochondral defects their use as such is considered a medically necessary part of the surgical procedure. Use of bone void fillers for treatment of delayed unions and nonunions is considered medically necessary when used as an adjunct to approved biologic or non biologic implants. Polymethylmethacrylate PMMA Antibiotic Beads. Soft Tissue Debridement Definition' title='Soft Tissue Debridement Definition' />Aetna considers PMMA antibiotic beads medically necessary for use in conjunction with intravenous antibiotics in the treatment of chronic osteomyelitis. Mesenchymal Stem Cell TherapyBone Marrow AspirateProgenitor Cells. Aetna considers the use of mesenchymal stem cell therapy e. Allo. Stem, Osteocel, Osteocel Plus, Ovation, Regenexx, and Trinity Evolution andor the use of progenitor cells experimental and investigational for all orthopedic applications including repair or regeneration of musculoskeletal tissue, osteochondritis dissecans, spinal fusion, and bone nonunions because there is insufficient evidence to support its use for these indications, especially its safety and long term outcomes. Aetna considers bone marrow injections medically necessary in the treatment of bone cysts unicameralsimple. Aetna considers the use of bone marrow aspirate experimental and investigational for all other orthopedic applications including nonunion fracture, repair or regeneration of musculoskeletal tissue, osteoarthritis, and as an adjunct to spinal fusion because there is insufficient evidence to support its use for these indications. Aetna considers hydroxyapatite bone substitute e. HTB1yKa7NXXXXXXWXpXXq6xXFXXXX/Medical-surgical-routine-basic-equipment-orthopedics-complete-sets-of-27pcs-of-the-soft-tissue-debridement.jpg' alt='Soft Tissue Debridement Definition' title='Soft Tissue Debridement Definition' />Oto. Mimix medically necessary for middle ear surgery. Aetna considers the following interventions experimental and investigational because there is insufficient evidence to support their use for these indications not an all inclusive list Acellular human dermal allograft e. Alloderm and Arthrex allograft for nasal septal repair. Actifuse silicated calcium sulphate as bone graft substitute. Anterior cruciate ligament derived stem cells for ligament tissue engineering. Anti microbial bone graft substitutes for the treatment of osteomyelitis. Arthrex biopaste Bio. Cartilage for glenoid osteochondral defects and other indications. Autologous stem cells for use after screw removal in orthopedic surgery. BIO Matr. X as bone graft substitute. Ceramic based products e. TCP when used alone or with bone marrow aspirate for the enhancement of bone healing andor fusion. Chron. OS bone graft substitute. Cook anal fistula plug. De. Novo NT natural tissue allogeneic minced cartilage graft. Gore anal fistula plug. Gracilis cadaveric graft for hallux valgus repair. Human growth factors e. Knee Creation nanocrystalline calcium phosphate bone substitute. Ligament and Joint Regeneration and Neuvo generation Medicine La. JRa. NMastergraft putty in spinal surgeries. Nan. Oss Bioactivenan. Oss Bioactive 3. D in spinal surgeries. Ossi. Mend putty in spinal surgeries. MCS Bone Graft. Pro. Dense calcium sulfatecalcium phosphate composite as bone graft substitute. Surgisis collagen plug for the treatment of anal fistulas. Tendon Wrap Tendon Protector. See also CPB 0. 74. Spinal Surgery Laminectomy and Fusion.