Knee Arthroplasty Medical Policy

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Knee Arthroplasty - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/600_699/0660.html

Scope of PolicyThis Clinical Policy Bulletin addresses knee arthroplasty. 1. 1.1. Food and Drug Administration (FDA) approved total knee arthroplasty (TKA) prosthesis is considered medically necessary for adult members when the following criteria are … See more

Surgery of the Knee - UHCprovider.com

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/surgery-knee.pdf

Surgery of the knee is proven and medically necessary in certain circumstances. For medical necessity clinical coverage criteria, refer to the InterQual® CP: Procedures: …

Surgery of the Knee – Oxford Clinical Policy

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/oxford/total-knee-replacement-surgery-arthoplasty-ohp.pdf

Surgery of the knee is proven and medically necessary in certain circumstances. For medical necessity clinical coverage criteria, refer to the InterQual® CP: Procedures: …

Knee replacement - Mayo Clinic

https://www.mayoclinic.org/tests-procedures/knee-replacement/about/pac-20385276

The procedure involves cutting away damaged bone and cartilage from your thighbone, shinbone and kneecap and replacing it with an artificial joint (prosthesis) made of metal alloys, high-grade …

7.01.550 Knee Arthroplasty in Adults - Premera Blue …

https://www.premera.com/medicalpolicies/7.01.550.pdf

Knee arthroplasty is the medical term for a total knee replacement. A surgeon removes the damaged part of the joint. The surfaces are shaped to hold a …

LCD - Total Knee Arthroplasty (L36575) - Centers for …

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=36575&DocID=L36575

CMS National Coverage Policy. Title XVIII of the Social Security Act, §1862 (a) (1) (A) allows coverage and payment for only those services that are considered to …

Total or Partial Knee Arthroplasty - Bright Health Plan

https://cdn1.brighthealthplan.com/docs/medical-policies/Med_Clin_Ops-009.pdf

Total Knee Arthroplasty is one of the most commonly performed orthopedic procedures, making it a key driver of health care costs. Many studies have demonstrated …

BSC7.10 Knee Arthroplasty for Adults - Blue Shield …

https://www.blueshieldca.com/bsca/bsc/public/common/PortalComponents/provider/StreamDocumentServlet?fileName=PRV_KneeArthroplasty_Adult.pdf

Total Knee Arthroplasty (TKA), also known as Total Knee Replacement (TKR), is a surgical procedure to replace the weight-bearing surfaces of the knee joint to …

Musculoskeletal Guidelines - AIM Specialty Health

https://aimspecialtyhealth.com/resources/clinical-guidelines/musculoskeletal/

The interventions addressed in the AIM Clinical Appropriateness Guidelines for Joint Surgery include total replacement of the hip, knee, and shoulder; arthroscopy of the hip, …

Provider Medical Policies | Anthem.com

https://www.anthem.com/provider/policies/clinical-guidelines/

Medical policies and clinical utilization management (UM) guidelines are two resources that help us determine if a procedure is medically necessary. These documents are available …

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