Palmetto GBA Says Thermal Capsulorrhaphy Non-Covered

Palmetto GBA, the Part B MAC for jurisdiction 1 and 11, has determined thermal capsulorrhapy not medically necessary due to the lack of clinical evidence to demonstrate improved health outcomes, according to an AAPC release.

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According to the report, thermal capsulorrhapy is proposed as a minimally invasive arthroscopic procedure to tighten the capsule and ligaments of joints for the treatment of joint instability, including the shoulder, knee and elbow. The Medicare administrative contractor announced April 7 that claims submitted for this service will be denied.

Jurisdiction 1 covers Northern California, Southern California, Nevada, Hawaii and the Pacific Islands and jurisdiction 11 covers North Carolina, South Carolina, Virginia and West Virginia.

Read the AAPC report on thermal capsulorrhaphy.

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