CPT 27486 · Other Procedure · Aetna
Revision TKA — One Component at Aetna.
How Aetna approaches CPT 27486 (Revision TKA — One Component) for prior-authorization review: at last review on 2025-08-22, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2025-08-22
Policy number
CPB-0661Criteria summary
High-level themes from the Aetna policy of record for CPT 27486. Verbatim policy text and per-criterion analysis are available after sign-in.
- Imaging concordance documentation required.
- Prior diagnostic procedure documentation required.
Source: Aetna Clinical Policy Bulletin 0661 — Total Hip Arthroplasty (Primary and Revision)
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