CPT 24363 · Other Procedure · BCBS Massachusetts
Total Elbow Arthroplasty at BCBS Massachusetts.
How BCBS Massachusetts approaches CPT 24363 (Total Elbow Arthroplasty) for prior-authorization review: at last review on 2026-05-03, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-03
Criteria summary
High-level themes from the BCBS Massachusetts policy of record for CPT 24363. 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: BCBS Massachusetts Medical Policy — Total Elbow Arthroplasty (CPT 24363)
See the full BCBS Massachusetts criteria.
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