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

Akshay Govind, Danielle Ploussard, Sydney Hoffman, Zhenzhen Zhang, Ying Wu

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To compare Medicare coverage patterns for treatments of knee osteoarthritis (OA) to those of temporomandibular joint (TMJ) OA. Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish (US)
JournalCranio - Journal of Craniomandibular Practice
DOIs
StateAccepted/In press - 2020

Keywords

  • Medicare
  • Temporomandibular joint
  • knee
  • osteoarthritis
  • pain

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Dentistry(all)

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