CPT 27447 · Other Procedure · Ambetter
Total Knee Arthroplasty (TKA) at Ambetter.
How Ambetter approaches CPT 27447 (Total Knee Arthroplasty (TKA)) for prior-authorization review: at last review on 2024-02-01, the policy covers this code with prior authorization required.
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Verification pending. This record is awaiting confirmation against the latest policy document — criteria summary may not reflect the current revision.
Criteria summary
High-level themes from the Ambetter policy of record for CPT 27447. 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: Ambetter Surgical Quality and Safety Management Program — TurningPoint Healthcare Solutions
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