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

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.

KEYWORDS:

• Temporomandibular joint
• knee
• osteoarthritis
• pain
• Medicare

Acknowledgments

We thank Dr. Charles McNeill for reviewing our manuscript.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

There were no sources of funding for this study.