CMM-407: Arthroscopy Subtalar Joint

Covered when subtalar arthroscopy is done for subtalar pain ≥3 months, loose body, synovitis, or subtalar arthritis with supporting subjective symptoms and objective exam findings, inconclusive imaging, documented plain radiographs (±MRI/CT as needed), and failure of ≥6 weeks of conservative care (NSAIDs, rest/activity modification, bracing/walker boot) including attempted subtalar corticosteroid injection unless contraindicated, with <50% global improvement. Not covered if there is intraarticular/soft-tissue infection, patient cannot benefit from surgery/rehab or has unsafe comorbidities, complete loss of joint space (except arthrodesis), peripheral vascular disease, inability to comply with weight‑bearing restrictions, or for emergent conditions (post‑reduction subtalar dislocation, septic arthritis) which require urgent referral.

"Objective physical exam findings include ANY of the following: Subtalar instability"