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March 2018
March 29, 2018: Please disregard the information in the article below. Blue Cross Blue Shield of Michigan and Blue Care Network will continue to cover hyaluronic acid injections until further notice, while we conduct additional research on this policy and its impacts. We’ll provide updates on this in web-DENIS and future issues of The Record. Members will receive a letter soon with the updated information.
Blue Cross, BCN no longer covering hyaluronic acids, starting April 1
To give the best value to our members, Blue Cross Blue Shield of Michigan and Blue Care Network commercial plans won’t cover hyaluronic acids starting on April 1, 2018.** Blue Cross and BCN will continue to cover first-line alternative therapies based on guideline recommendations for treatment of pain in knee osteoarthritis. To get information on the types of covered drug therapy for pain management, refer to our approved drug list.
If you’ve prescribed hyaluronic acid therapy, be sure to complete all regimens by March 31, 2018. Starting April 1, 2018, we won’t cover these injections:
J code |
Drug description |
J7320 |
Hyaluronan or derivative, Genvisc® 850 for intra-articular injection, 1 mg. |
J7321 |
Hyaluronan or derivative, Hyalgan® for Supartz™ 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-Syn™ for intra-articular injection, 0.1 mg |
Future
J codes |
Future Hyaluronan or derivative products, not yet approved by the FDA |
About hyaluronic acids
Hyaluronic acids, also known as viscosupplements, are used to treat osteoarthritis of the knee. A large body of evidence from randomized controlled trials and national guidelines have examined the effect of hyaluronic acids on pain and function. The data shows that there’s insufficient evidence of hyaluronic acid therapy improving the net health outcome in patients with knee osteoarthritis due to:
- A lack of defined meaningful clinical improvements over placebo
- Well-characterized biases among trials
- Publication bias
- Missing study results
**These changes don’t apply to Medicare, Medicaid and Federal Employee Program members.
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