Blue Cross Blue Shield of Michigan reversed its decision to stop covering knee arthritis injections as it reviews their effectiveness, the Detroit Free Press reports.
Here are seven things to know.
1. Blue Cross will continue to pay for hyaluronic acid injections, also known as viscosupplementation therapy, as it reviews information about the injections.
2. In January, Michigan's largest health insurer announced its decision to stop covering the injections starting April 1.
3. Without coverage, patients who receive the shots would have had to pay roughly $450 to $1,000 out of pocket.
4. Some patient advocates and orthopedists, including members of the Michigan Orthopedics Society, claim the injections reduce pain, improve mobility and delay the need for a knee replacement for arthritis sufferers. Knee replacement surgeries are covered by private insurance and Medicare and can cost $28,000 or more, including physical therapy expenses.
5. In 2013, the American Academy of Orthopaedic Surgeons stopped recommending hyaluronic acid knee injections "based on a lack of efficacy, not on potential harm." An AAOS study of 86,000-plus patients insured by Humana suggested the knee injections lead to millions in unnecessary costs, since patients end up getting joint replacements.
6. Grand Rapids, Mich.-based Priority Health stopped covering the treatments in 2014. Medicare still covers hyaluronic acid injections for patients every six months.
7. Blue Cross has not revealed when it expects to make a final decision on the injections.
More articles on coding, billing, and collections:
AdvantEdge Healthcare Solutions expands billing services through acquisition — 4 insights
12 statistics on ASC days cash on hand
CMS to terminate Medicare benefits of The Eye Surgeons Group of Tacoma — 6 insights