CPT 23472 · Other Procedure · Veterans Affairs
Total Shoulder Arthroplasty (TSA / Reverse TSA) at Veterans Affairs.
How Veterans Affairs approaches CPT 23472 (Total Shoulder Arthroplasty (TSA / Reverse TSA)) for prior-authorization review: at last review on 2026-05-11, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-11
Criteria summary
High-level themes from the Veterans Affairs 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 Veterans Affairs criteria.
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