Well I have agreed to a staging scope that will pave the way to get the osteochondral allograft approved. However, I was browsing BCBS of IL's medical policy manual this evening, because that's what I call fun, and found this zinger:
"Osteochondral autografting or allografting for joints other than the knee is considered experimental, investigational and/or unproven, including but not limited to the patellar (knee cap) and talar (ankle)."
So now I don't know what to think. My scope is on the 21st. Now it looks like the allograft might not be authorized since it's on my patella.
The maddening part is that the top of the page says:
"Osteochondral allografting may be considered medically necessary as a technique to repair full-thickness chondral defects of the knee caused by acute or repetitive trauma when other cartilage repair techniques (e.g., microfracture, osteochondral autografting or autologous chondrocyte implantation) would be inadequate due to the size, location, or depth of the lesion."
And then it goes on to quote a bunch of studies that show good results on the patella...but they still consider the patellar procedure experimental.
