Wiki Denovo juvenile cartilage allograft

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CJoy0724

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Is anyone using the Denovo juvenile cartilage graft to repair chondral defects in the knee?? We did our first one a few months ago and are having a hard time getting paid. We billed with the unlisted code 27599, using 27412 as a comparison code. BCBS of MI requested the notes to process the NOC code, and are now denying stating the procedure is experimental. I have been told to do an Ombudsman appeal, but need clinical documentation showing the procedure is effective. I have 2 questions really, First has anyone else billed for this and are you using the unlisted or 27412? Second, does anyone have any suggestions of where I can find clinical research on this? I have contacted the company that supplied the graft and have so far not recieved any response. Any help would be MUCH appreciated.
Thanks!
 
I called the Zimmer Hotline directly...talked to Kathy Miles...very helpful!! 1-866-949-0444 She emailed me information regarding how & why the procedure is done. We use the unlisted procedure for the knee and compare it to CPT 27415....hope this information is helpful.
Tammy
 
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