Core Decompression for Avascular Necrosis

Aetna covers core decompression (HCPCS S2325) as medically necessary for early/pre‑collapse (stage I–II, before X‑ray changes) avascular necrosis of the femoral head/neck when the plan’s selection criteria and listed ICD‑10 codes are met. Core decompression is excluded as experimental/investigational for other joints, late/post‑collapse (stage III+) or post‑arthroscopic osteonecrosis, and numerous adjunctive treatments (e.g., bone marrow/stem cells, PRP, bisphosphonates, BMPs, synthetic grafts, extracorporeal shockwave, etc.) are also considered investigational and not covered.

"“When bilateral core decompression is indicated, it can be done simultaneously on both hips."

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