CPT 23472 · Arthroplasty — Shoulder · Cigna
Total Shoulder Arthroplasty (TSA / Reverse TSA) at Cigna.
How Cigna approaches CPT 23472 (Total Shoulder Arthroplasty (TSA / Reverse TSA)) for prior-authorization review: at last review on 2025-10-01, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2025-10-01
Policy number
CMM-ORTHO-23472Criteria summary
High-level themes from the Cigna 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.
See the full Cigna criteria.
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