CPT 23472 · Arthroplasty — Shoulder · Pennsylvania Bureau of Workers' Comp
Total Shoulder Arthroplasty (TSA / Reverse TSA) at Pennsylvania Bureau of Workers' Comp.
How Pennsylvania Bureau of Workers' Comp approaches CPT 23472 (Total Shoulder Arthroplasty (TSA / Reverse TSA)) for prior-authorization review: at last review on 2026-05-02, the policy covers this code with prior authorization required.
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PA-BWC-2026Criteria summary
High-level themes from the Pennsylvania Bureau of Workers' Comp policy of record for CPT 23472. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 16 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: PA Bureau of Workers' Comp — utilization review per Act 44
See the full Pennsylvania Bureau of Workers' Comp criteria.
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