CPT 29888 · Arthroscopy — Knee
Knee Arthroscopy — ACL Reconstruction
Knee Arthroscopy — ACL Reconstruction (29888) — payor coverage and prior-authorization requirements across all Medicare MACs, commercial payors, BCBS plans, and Medicaid programs tracked by Rubrica.
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Rubrica tracks payor coverage for CPT 29888 (Knee Arthroscopy — ACL Reconstruction) across 62 payors — every Medicare MAC, the major commercial plans, the BCBS family, all 50-state Medicaid programs, and selected workers' comp and auto/PIP carriers. Aggregate coverage patterns are shown below; full payor-specific criteria, source citations, and last-reviewed dates are available to signed-in practitioners.
Top payors covering CPT 29888
Sample of 12 payors with coverage for this code. Sign in for the complete payor list, verbatim criteria, denial-risk score, and source citations for each.
| Payor | Coverage | Prior auth |
|---|---|---|
| Aetna | Covered | Prior auth |
| Aetna Medicare Advantage | Covered | Prior auth |
| Ambetter | Covered | Prior auth |
| Anthem BCBS | Covered | Prior auth |
| BCBS Alabama | Covered | Prior auth |
| BCBS Federal Employee Program | Covered | Prior auth |
| BCBS Illinois | Covered | Prior auth |
| BCBS Massachusetts | Covered | Prior auth |
| BCBS Michigan | Covered | Prior auth |
| BCBS Montana | Covered | Prior auth |
| BCBS New Mexico | Covered | Prior auth |
| BCBS Oklahoma | Covered | Prior auth |
Coverage themes for CPT 29888
Common patterns across the 62 payors we track. Specific criteria per payor are available after sign-in.
Conservative care requirements vary by payor for 29888.
59 of 62 payors require imaging concordance documentation.
Of the 62 payors with coverage records for CPT 29888, 52 require prior authorization, 10 cover without prior authorization, and 0 flag the procedure as investigational or experimental under current criteria.
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