S2117, Arthroereisis, subtalar
HCPCS/CPT
Prior Authorization
Prior Auth Required
Code explicitly requires prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- No specific documentation requirements (medical records, test results, or clinical notes) are stated in this Clinical Policy Bulletin.
- Providers must use the most appropriate codes as of the effective date of the submission; claims for services not accompanied by covered codes under this Coverage Policy will be denied as not covered.
- When billing, services must be submitted in accordance with the relevant criteria outlined in the applicable Coverage Policy, including covered diagnosis and/or procedure code(s).
- Coverage determinations require consideration of: (1) the terms of the applicable benefit plan document in effect on the date of service; (2) any applicable laws/regulations; (3) any relevant collateral source materials including Coverage Policies; and (4) the specific facts of the particular situation. (Policy statement under "Instructions for Use")
Key Coverage Criteria
- None — Subtalar joint implantation (subtalar arthroereisis/extraosseous talotarsal stabilization) is considered experimental, investigational or unproven for ANY indication.
- Explicit examples of indications called out as NOT supported: "rigid or flexible pes planus (i.e., flatfoot)"
- Explicit examples of indications called out as NOT supported: "posterior tibial tendon dysfunction"
- Explicit examples of indications called out as NOT supported: "talotarsal joint subluxation/dislocation"
- 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).
11 Active Policies
ANTHEM-SURG.00104, SURG.00104 Extraosseous Subtalar Joint Implantation and Subtalar Arthroereisis
AETNA-CPB-0669, Subtalar Implant for Foot Deformity
SUR705.027, Subtalar Arthroereisis
BCBSIL-SUR705.027, Subtalar Arthroereisis
BCBSMT-SUR705.027, Subtalar Arthroereisis
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.