SURG.00147 Synthetic Cartilage Implant for Metatarsophalangeal Joint Disorders Form
Procedure is not covered
This document addresses the use of a metatarsophalangeal synthetic cartilage implant. These implants may be used as a treatment for hallux limitus or hallux rigidus in the first metatarsophalangeal joint with or without the presence of mild hallux valgus, or for other metatarsophalangeal joint disorders.
Position Statement
Investigational and Not Medically Necessary:
Use of a metatarsophalangeal synthetic cartilage implant (consisting of biocompatible, molded cylindrical hydrogel) is considered investigational and not medically necessary as a treatment for metatarsophalangeal joint disorders including but not limited to hallux limitus or hallux rigidus.
Walk through this policy with us
Review how this policy can be converted into cited criteria, prior authorization checks, and operational automation.