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Medicare coverage patterns favor non-invasive and minimally-invasive treatments of knee osteoarthritis compared to temporomandibular joint osteoarthritis

Authors :
Zhenzhen Zhang
Danielle Ploussard
Akshay Govind
Sydney Hoffman
Ying Wu
Source :
CRANIO®. 41:144-150
Publication Year :
2020
Publisher :
Informa UK Limited, 2020.

Abstract

To compare Medicare coverage patterns for treatments of knee osteoarthritis (OA) to those of temporomandibular joint (TMJ) OA.The International Classification of Diseases (ICD)-10 codes were used to identify knee OA, TMJ OA, and related diagnoses. The AAPC Coder was utilized to search for Medicare insurance coverage by state/district for the indicated CPT codes. The coverage for treatments of TMJ OA and knee OA was analyzed by Fisher's exact test.There was a statistically significant difference in the coverage of physical therapy, massage therapy, and arthrocentesis for TMJ OA and knee OA. The current study showed that arthrocentesis was covered 100% in all states/districts for knee OA and 0% for TMJ OA.Medicare covers TMJ OA treatments to a lesser degree than knee treatments. Documentation of this discrepancy serves as an important first step in advocating for improvements in coverage, and subsequently, in access to care.

Details

ISSN :
21510903 and 08869634
Volume :
41
Database :
OpenAIRE
Journal :
CRANIO®
Accession number :
edsair.doi.dedup.....9c70dd33251fa11b92d378b9bef3fdf5