0511T — Rmvl&rinsj sinus tarsi implt
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- Documentation of review of the member's benefit contract or Summary Plan Description (SPD) to confirm coverage, exclusions, and any dollar or duration limits.
Key Coverage Criteria
- Subtalar arthroereisis/extraosseous talotarsal stabilization to correct excessive talar displacement and calcaneal eversion by reducing pronation across the subtalar joint.
- Extraosseous talotarsal stabilization being evaluated as a treatment for talotarsal joint dislocation (investigational/under evaluation).
- Insertion of the Maxwell-Brancheau Arthroereisis implant may be offered as a stand‑alone procedure in children.
- Subtalar arthroereisis (including Maxwell-Brancheau, HyProCure, subtalar arthroereisis peg, Kalix) may be performed in children and adults often in conjunction with adjunctive bone and soft-tissue procedures to correct additional deformities.
- Insertion into the sinus tarsi to allow normal subtalar joint motion while blocking excessive pronation.
- Flexible flatfoot characterized by excessive pronation during weight-bearing due to anterior and medial displacement of the talus
6 Active Policies
BCBSIL-SUR705.027 — Subtalar Arthroereisis
BCBSMT-SUR705.027 — Subtalar Arthroereisis
BCBSNM-SUR705.027 — Subtalar Arthroereisis
BCBSOK-SUR705.027 — Subtalar Arthroereisis
REGENCE-SUR144 — Subtalar Arthroereisis
Related Codes
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