Autologous Chondrocyte Implantation (ACI) is a two-stage surgical technique in which a small portion of the patient’s own cartilage is harvested in Stage 1, sent to a lab to culture and grow the chondrocytes and then in Stage 2 those chondrocytes are re-implanted back into the knee.
Originally, physicians were using Carticel which was injected under a patch into the cartilage defect and over time the product would harden and create new cartilage growth within the defect. The difference between Carticel and MACI is that with MACI the chondrocytes are impregnated onto a porcine collagen membrane using a proprietary technique that “delivers a controlled, uniform dose of cells” to the collagen membrane.
Stage 2 is performed as an open procedure where the cartilage defect will be templated for the appropriate size, the collagen membrane is then cut to fit the defect and will be placed with fibrin glue to fixate the implant in place.
Many carriers consider MACI as an acceptable alternative to Carticel but there are still Coverage Guidelines that need to be met, such as full thickness cartilage defects of a specific size, treatment of the femur only and no osteoarthritis to name a few.
For Stage 1 of the procedure report 29870 when the cartilage biopsy is harvested arthroscopically.
For Stage 2 of the procedure report 27412 Autologous chondrocyte implantation, knee.
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