Payer PolicyActive
Knee Ligament Arthrometer Testing
AETNA-CPB-0397
Aetna
Effective: June 6, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna considers knee ligament arthrometer testing experimental/investigational and not covered for evaluating knee ligament laxity or other indications due to inadequate reliability, low inter-rater agreement, device-specific measurement errors, and lack of demonstrated clinical utility. It cannot replace physical examination or MRI, CPT codes 95851 and 97750 are not covered for these indications, and there is no specific CPT/HCPCS code for arthrometer testing.
Coverage Criteria Preview
Key requirements from the full policy
"None — Knee ligament arthrometer testing is considered experimental and investigational for evaluating ligament laxity in the knee or for other indications because the peer-reviewed medical literat..."
Sign up to see full coverage criteria, indications, and limitations.