Total Ankle Replacement (TAR)

This policy covers total ankle replacement (TAR) for skeletally mature adults with moderate-to-severe tibiotalar pain from end-stage ankle arthritis (including severe rheumatoid, osteoarthritis, or post‑traumatic arthritis) who have failed ≥6 months of conservative therapy, and permits revision TAR for failed implants (revision cases are exempt from the ≥6‑month conservative‑treatment requirement). Coverage requires use of FDA‑approved devices, performance by surgeons experienced with the specific implants and techniques, and patient ability to participate in postoperative rehabilitation, and excludes patients with contraindications such as active or prior joint infection, extensive talar avascular necrosis, poor bone/soft‑tissue stock, severe uncorrectable malalignment (>15°), peripheral vascular disease, neuropathy/Charcot arthropathy, and is subject to applicable member benefit plan limits.

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