CPT 27130 · Other Procedure · BCBS New Mexico
Total Hip Arthroplasty (THA) at BCBS New Mexico.
How BCBS New Mexico approaches CPT 27130 (Total Hip Arthroplasty (THA)) for prior-authorization review: at last review on 2026-01-01, the policy covers this code with prior authorization required.
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Carelon Joint Surgery 2025-11-15Criteria summary
High-level themes from the BCBS New Mexico policy of record for CPT 27130. 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: Carelon Clinical Appropriateness Guidelines — Joint Surgery (delegated UM for HCSC/BCBS Montana)
See the full BCBS New Mexico criteria.
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