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Author Topic: DeNovo NT - Patella  (Read 778 times)

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Offline Tricare

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DeNovo NT - Patella
« on: September 03, 2015, 03:01:48 AM »
My 14 year old daughter recently had surgery on cartilage damage to her patella.   I'm a service member with the National Guard so our insurance is through Tricare West which is managed by United Health Care.  Tricare will not cover the use of DeNovo NT.  We are working through the appeal process but I'm told there have been cases in the 'East' where Tricare has approved and paid for the use of De Novo NT.  These are situations where Tricare is managed by other commercial insurance carriers.  I'm looking for information where someone has had DeNovo NT used and covered by Tricare, the military insurance provider.  Any information would be helpful.
Thank you.

Offline willrunagain

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Re: DeNovo NT - Patella
« Reply #1 on: September 03, 2015, 05:55:46 PM »
Hi there. Denovo is notoriously difficult to get approval for regardless of your insurance provider.  Most deemit experimental.  I'm 26 and have a patella defect as well.  I fought with my insurance for 2 months and lost. 

Through extensive self research, I found out about cartiform. It is an osteochondral allograft (human donor cartilage) that is cryopreserved and can be implanted whenever the patient needs it.  Funny thing is it only took my insurance two weeks to approve this procedure.  I am scheduled for the surgery this tuesday (9/8).  Look into cartiform if you can.  It has only been out for a year, but the clinical results so far are superior when compared to Denovo.

Where are you located?  There are only a few surgeons in the US that are trained with cartiform