CMM-407: Arthroscopy Subtalar Joint

Subtalar joint arthroscopy is medically necessary for conditions such as ≥3 months of indeterminate subtalar pain, loose body, synovitis, or arthritis (arthrodesis) when corresponding subjective and objective findings support the diagnosis, and is excluded for intraarticular/surrounding infection, significant medical comorbidities or inability to rehabilitate, loss of complete joint space (except arthrodesis), peripheral vascular disease, or inability to comply with weight‑bearing restrictions. Key requirements: plain radiographs ± MRI/CT with inconclusive/confirmatory findings, documented failure of ≥6 weeks of conservative therapy (NSAIDs, bracing/activity modification, walker boot, and subtalar corticosteroid injection unless contraindicated) with <50% global improvement, and documentation that surgery/anesthesia is safe and the patient can comply with post‑op restrictions.

"Subtalar joint arthroscopy is considered medically necessary when all of the following are met:"