Surgery of the Foot – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers cheilectomy/debridement/capsular release without implant for mild-to-moderate hallux limitus/rigidus and with implant (hemi/total arthroplasty) for moderate-to-severe hallux rigidus when InterQual® clinical criteria are met. Key requirements: radiographic confirmation of severity, documented failure of conservative therapy (orthotics/shoe modification, medical therapy or injections, activity modification), required medical-record documentation; osteochondral grafting (allograft/autograft) and cheilectomy without implant for severe hallux rigidus are considered unproven and not medically necessary.

" - "Debridement of hyperkeratotic lesions, if present""

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