Stem cell therapy (e.g., intra-articular injections of adipose tissue-derived stem cells, bone marrow-derived mononuclear cell, infra-patellar fat pad-derived mesenchymal stem cell or pre-cartilaginous stem cells).Percutaneous calcium phosphate injections.Intra-articular injections of autologous conditioned serum.Intra-articular botulinum toxin injections.

Cryotherapy (e.g., Iovera cryoneurolysis).

Combination of high tibial osteotomy and autologous bone marrow derived cell implantation.Arthroscopic debridement for persons with osteoarthritis presenting with knee pain only or with severe osteoarthritis (Outerbridge classification III or IV Footnotes for outerbridge scale.*).Advanced Arthritis Relief Protocol (which includes stem cell therapy).Aetna considers arthroscopic debridement (with or without partial meniscectomy) medically necessary for persons presenting with mild-to-moderate (Outerbridge classification I and II, not III or IV) osteoarthritis (OA) with knee pain plus mechanical symptoms due to loose bodies and/or meniscal tears.Īetna considers arthroscopic partial meniscectomy medically necessary for traumatic meniscal tears unless there is moderate or severe osteoarthritis present (Outerbridge classification III or IV).Īetna considers arthroscopic partial meniscectomy experimental and investigational for degenerative meniscal tears.Īetna considers intra-articular glucocorticoid injections medically necessary for the treatment of knee OA.Īetna considers the following interventions experimental and investigational because the effectiveness of these approaches has not been established:

Icd 10 code for osteoarthritis