CPT 23472 · Other Procedure · BCBS Tennessee
Total Shoulder Arthroplasty (TSA / Reverse TSA) at BCBS Tennessee.
How BCBS Tennessee approaches CPT 23472 (Total Shoulder Arthroplasty (TSA / Reverse TSA)) for prior-authorization review: at last review on 2026-01-01, the policy covers this code with prior authorization required.
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BCBST MPM — Joint SurgeryCriteria summary
High-level themes from the BCBS Tennessee policy of record for CPT 23472. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: BlueCross BlueShield of Tennessee Medical Policy Manual — Orthopedic Surgery / Joint Surgery
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