When you read "coverage" in an insurance companies

When you read "coverage" in an insurance companies policy, you have to read through the document. Especially with Medicare. I may be wrong but I recall a Qcode discussion from 3 ish years ago. If you click on the links for the local coverage determination (LCD) for each of the Medicare Area Contractors (MAC), you will find these Qcode products are/may not be coverered due to the potential for abuse of the Medicare system. This reads as just a normal annual coverage summary update with modest changes.

I have used amniotic/stem cell products with their unique own Qcodes for a while in my practice. Generally speaking, they tend to be considered by Medicare "investigational" with some exceptions. Unfortunately, companies like Olaregen have never funded large studies with enough patients to prove to Medicare these products are effective enough to be worth paying hundreds or thousands of dollars for vs the cheaper biologics currently available. Dozens of these products exist. Based on what I've read Excellagen is a good product, better than many, but coverage by Medicare is a high bar and Olaregen/Generex went for the VA's contract system. Rightfully so.

I think Krilac could be helpful with this should he be inclined to chime in.