Femoro-Acetabular Surgery for Hip Impingement Syndrome

Aetna covers open or arthroscopic femoro‑acetabular surgery for FAI only when all criteria are met: radiologic confirmation of FAI with labral pathology and cam/pincer/pistol‑grip morphology, moderate–severe symptoms ≥6 months, a positive impingement sign, failure of ≥12 weeks conservative care (including ≥6 weeks in‑person physiotherapy) within the past year, and age ≥15 or skeletally mature. Diagnostic arthroscopy (CPT 29860) is generally not covered unless intraoperative pathology is absent, CPT 29862 debridement is integral/not separately payable, and isolated arthroscopic debridement and procedures such as iliopsoas release, capsular plication/release, endoscopic tenotomy, labrum reconstruction, osteochondral mosaicplasty, microfracture, partial gluteus medius repair, lesser trochanteric resection, hip arthroscopy for degenerative labral tears, and arthroscopy for acetabular dysplasia without osteotomy are experimental/investigational or not covered.