A new policy for the surgical treatments of athletic pubalgia (AP) will be
effective for dates of service on or after March 5, 2013.
AP is a condition associated with chronic groin pain and primarily affects
professionally trained athletes. AP is most prevalent among athletes who
participate in sports that require running, changes in direction, and
repetitive kicking such as ice hockey, soccer, rugby, or football. AP has also
been called athletic hernia, sports hernia, sportsman?s hernia, sportsman?s
groin, soft groin, and Gilmore?s groin, among other names.
There are limited studies that compare the effectiveness of any particular
surgical approach to conservative treatment of AP. Although some studies have
suggested that an open or laparoscopic surgical approach to treat AP may
provide successful outcomes, these studies are of low quality and do not
appropriately compare the effectiveness of AP surgery to conservative treatment.
A lack of consensus regarding the etiology, diagnosis, and treatment of AP
warrants the need for further research. Therefore, at this time, we must
categorize surgical treatment for AP as experimental and investigational.
Please visit the
Medi
cal Policy section of our website to review the
Notificatio
n for Medical Policy #11.14.26: Surgical Treatments of Athletic Pubalgia.
If you have any questions, please contact your Network Coordinator.