Does C8003 require prior authorization?

Yes, C8003 requires prior authorization (high confidence). Code explicitly requires prior authorization.

`C8003`, Implantation of medial knee extraarticular implantable shock absorber spanning

HCPCS/CPT

Prior Auth Required

Code explicitly requires prior authorization (high confidence)

Review the member's benefit contract or Summary Plan Description (SPD) to determine defined coverage, exclusions, and benefit limitations.
Use the written Medical Policy coverage position (not the coding tables) when making benefit coverage determinations.

Treatment of medial compartment knee osteoarthritis to reduce loads on the intraarticular medial joint surface and improve symptoms.
Use in patients who have failed prior surgical or non-surgical treatment modalities for knee osteoarthritis (per FDA authorization).
Implantation of a shock/load absorber for mild-to-moderate symptomatic medial knee osteoarthritis only when performed within a research context or clinical trial comparing it to existing management.
Treatment of osteoarthritis of the knee using a medial knee implantable shock absorber device.

ANTHEM-SURG.00162, SURG.00162 Implantable Shock Absorber for Treatment of Knee Osteoarthritis

BCBSIL-SUR705.051, Use of a Medial Knee Implantable Shock Absorber

BCBSMT-SUR705.051, Use of a Medial Knee Implantable Shock Absorber

BCBSNM-SUR705.051, Use of a Medial Knee Implantable Shock Absorber

BCBSOK-SUR705.051, Use of a Medial Knee Implantable Shock Absorber

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