Hammertoe Repair

Aetna covers surgical hammertoe repair (including claw and mallet toe) only for skeletally mature patients (documented epiphyseal closure or age ≥18) when radiographic (AP and lateral) confirmation, specific surgical indications, and persistent pain/difficulty walking after at least 3 months of conservative treatment under a healthcare professional are documented; repairs for skeletally immature patients or when these criteria are not met are excluded. Internal fixation implants listed in the policy (e.g., Acumed Hammertoe Fusion Set, Smart Toe, CannuLink, etc.) are considered experimental/investigational and not covered.

"For repeat hammertoe surgery, documentation that the previous surgical procedure failed and reasoning for revision."

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