While this press release from an orthopedic implant company may not seem important, since many patients don’t even know what a CPT code is, it’s actually very significant.
New procedures are typically not covered by insurance companies, so when we try to get approval to perform these surgeries, we often hear back that the procedure has been denied as “investigational.”
However, when an implant is given a CPT, or Common Procedural Terminology, code, the pathway for reimbursement becomes streamlined, increasing the likelihood that patients can actually receive state-of-the-art care.
The CARTIHEAL AGILI-C Cartilage Repair Implant is made from coral and designed to treat cartilage defects of the knee. It can be used in patients with early arthritis. The implant received Breakthrough Device approval from the FDA over three years ago and has shown considerable promise in the 35 to 40 patients in whom I have used it so far. The American Medical Association (AMA) CPT Editorial Panel has established a Category I CPT code for procedures involving its CARTIHEAL AGILI-C Cartilage Repair Implant, effective January 1, 2027.
Read the Smith+Nephew press release: Smith+Nephew announces new category I CPT® code for its CARTIHEAL™ AGILI-C™ Cartilage Repair Implant.
