Total Ankle Arthroplasty/Replacement - (0285)

Cigna covers total ankle arthroplasty/replacement with an FDA‑approved device (and revision TAR for implant failure) as medically necessary as an alternative to ankle arthrodesis, but considers TAR combined with a total talar prosthesis and TAR for any other indications experimental/not medically necessary. Coverage requires documentation of skeletal maturity, severe inflammatory/osteoarthritis or post‑traumatic arthritis, function‑limiting moderate–severe ankle pain ≥3 months that interferes with ADLs or work, failure of ≥6 months conservative therapy, absence of listed contraindications (e.g., active infection, insufficient bone/neuropathy/vascular insufficiency, severe deformity), use of an FDA‑approved device, and appropriate CPT/HCPCS coding.

"Total ankle arthroplasty/replacement with a U."

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