27599
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- No explicit documentation requirements or required clinical record elements are stated in this policy.
- When deciding coverage, the member specific benefit plan document must be referenced as the terms of the member specific benefit plan may differ from the standard plan.
- Before using this policy, check the member specific benefit plan document and any applicable federal or state mandates.
- No specific documentation requirements are provided in this document chunk; follow documentation requirements specified in the applicable MAC LCDs/LRAs and CMS guidance.
Key Coverage Criteria
- None — Computer-assisted surgical navigation for musculoskeletal procedures of the pelvis and appendicular skeleton is unproven and not medically necessary due to insufficient evidence of efficacy.
- None — The use of an intra-operative sensor for implant stability during knee replacement arthroplasty and for improved knee function post-operatively is unproven and not medically necessary due to insufficient evidence of efficacy.
- Total joint arthroplasty — inferred from policy title (Total Joint Arthroplasty).
- Total knee arthroplasty — inferred as a likely covered procedure given the source document name (HUMANA-KNEE-ARTHROPLASTY), though no explicit indication text is present in the provided excerpt.
- Total Knee Arthroplasty (as referenced by LCD titles in the document)
- Lower Extremity Major Joint Replacement (Hip and Knee) (as referenced by LCD title L36007)
20 Active Policies
UMR-POL-UMR-computer-assisted-surg-nav-musculoskeletal-procs — Computer-Assisted Surgical Navigation for Musculoskeletal Procedures
SUREST-POL-SUREST-computer-assisted-surg-nav-musculoskeletal-procs — Computer-Assisted Surgical Navigation for Musculoskeletal Procedures
HUMANA-ALLOGRAFT-TRANSPLANTATION-OF-THE-KNEE-MA — Allograft Transplantation of the Knee - Medicare Advantage
HUMANA-KNEE-ARTHROPLASTY-MA — Knee Arthroplasty - Medicare Advantage
Related Codes
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