Blue Cross and Blue Care Network will no longer cover hyaluronic acids, starting April 1
Blue Cross Blue Shield of Michigan PPO (commercial) and Blue Care Network HMOSM (commercial) plans won't cover hyaluronic acids, beginning April 1, 2018.
Hyaluronic acids, also known as viscosupplements, are used to treat osteoarthritis of the knee.
Randomized controlled trials and national guidelines have examined the effect of hyaluronic acids on pain and function. The combined data show:
- A lack of defined meaningful clinical improvements over placebo
- Well-characterized biases among trials
- Publication bias
- Missing study results
Effective April 1, 2018, the following hyaluronic acids will be considered investigational and won't be covered for Blue Cross and BCN commercial (non-Medicare) members.
| J code | Drug description |
|---|---|
| J7320 | Hyaluronan or derivative, GenVisc® 850 for intra-articular injection, 1 mg |
| J7321 | Hyaluronan or derivative, Hyalgan® for SupartzTM for intra-articular injection, per dose |
| J7322 | Hyaluronan or derivative, Hymovis® for intra-articular injection, 1 mg |
| J7323 | Hyaluronan or derivative, Euflexxa® for intra-articular injection, per dose |
| J7324 | Hyaluronan or derivative, Orthovisc® for intra-articular injection, per dose |
| J7325 | Hyaluronan or derivative, Synvisc® or Synvisc-One® for intra-articular injection, 1 mg |
| J7326 | Hyaluronan or derivative, Gel-One® for intra-articular injection, per dose |
| J7327 | Hyaluronan or derivative, Monovisc® for intra-articular Injection, per dose |
| J7328 | Hyaluronan or derivative, Gel-SynTM for intra-articular injection, 0.1 mg |
| Future J codes | Future hyaluronan or derivative products, not yet approved by the FDA |
Posted: January 2018
Line of business: Blue Cross and Blue Care Network