Aetna Artificial Intervertebral Disc Surgery (Lumbar Spine) prior authorization requirements (2026)

What Aetna generally requires to approve Artificial Intervertebral Disc Surgery (Lumbar Spine) (CPT 22857, 22860, 22862, 22865), for Commercial plans. Yes. Aetna generally requires prior authorization for Artificial Intervertebral Disc Surgery (Lumbar Spine) (CPT 22857, 22860, 22862, 22865).

General reference compiled from public sources, last verified 2026-05-06. This is not a coverage determination or medical advice. Always confirm current requirements with Aetna before submitting.

Medical-necessity criteria Aetna generally applies

Medical necessity review required

Diagnoses that commonly support medical necessity

ICD-10-CM diagnoses frequently associated with medical necessity for Artificial Intervertebral Disc Surgery (Lumbar Spine). Confirm the covered diagnosis list against the current Aetna policy.

M51.36Other intervertebral disc degeneration, lumbar regionM51.26Other intervertebral disc displacement, lumbar region

Commonly required documentation

  • All medical records requested must be submitted

How to submit

  • Method: portal
  • Typical turnaround: about 3 days

Source

Precertification required for all applicable plans Last verified 2026-05-06.

Frequently asked questions

Does Aetna require prior authorization for Artificial Intervertebral Disc Surgery (Lumbar Spine)?

Yes. Aetna generally requires prior authorization for Artificial Intervertebral Disc Surgery (Lumbar Spine) (CPT 22857, 22860, 22862, 22865).

What does Aetna require to approve Artificial Intervertebral Disc Surgery (Lumbar Spine)?

Medical necessity review required Always confirm against the current Aetna policy.

How long does a Aetna prior authorization take?

Aetna typically decides Artificial Intervertebral Disc Surgery (Lumbar Spine) requests in about 3 days. Timeframes vary; check the payer portal.

Submitting Artificial Intervertebral Disc Surgery (Lumbar Spine) to Aetna?

Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.

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Other Aetna prior authorization requirements

ACL ReconstructionAnterior Cervical Discectomy and FusionArthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairArtificial Intervertebral Disc Surgery (Cervical Spine)Autologous Chondrocyte ImplantationBunionectomy (Hallux Valgus Correction)Cervical, Lumbar and Thoracic Laminectomy and/or Laminotomy ProceduresChiari Malformation Decompression SurgeryCochlear Device and/or ImplantationCT Abdomen and Pelvis with contrastCTA Chest (e.g., pulmonary embolism)Custom Foot Orthotics

Related guides

Why was my prior authorization denied? Top reasons and how to fix eachHow to write a prior authorization appeal that cites policy