Aetna MRI Lower Extremity Joint without contrast prior authorization requirements (2026)
What Aetna generally requires to approve MRI Lower Extremity Joint without contrast (CPT 73721), for Commercial plans. Yes. Aetna generally requires prior authorization for MRI Lower Extremity Joint without contrast (CPT 73721).
Medical-necessity criteria Aetna generally applies
Knee MRI without contrast is appropriate (per ACR Appropriateness Criteria for Chronic Knee Pain) when initial radiographs are normal/effusion, show OCD/loose bodies or prior cartilage/meniscal repair, or internal derangement is suspected. Obtain radiographs first.
Situations to verify before submitting
Aetna may not cover MRI Lower Extremity Joint without contrast in these situations. Verify against the current policy rather than assuming a denial:
- {"text":"Chronic knee pain imaged with MRI before obtaining initial knee radiographs (radiographs are the appropriate first study per ACR criteria)","source":"ACR Appropriateness Criteria: Chronic Knee Pain"}
Source
Advanced imaging PA for Aetna is managed by eviCore. Criteria summarized from ACR Appropriateness Criteria Chronic Knee Pain. Source: jacr.org; eviCore radiology program. Last verified 2026-06-12.
Frequently asked questions
Does Aetna require prior authorization for MRI Lower Extremity Joint without contrast?
Yes. Aetna generally requires prior authorization for MRI Lower Extremity Joint without contrast (CPT 73721).
What does Aetna require to approve MRI Lower Extremity Joint without contrast?
Knee MRI without contrast is appropriate (per ACR Appropriateness Criteria for Chronic Knee Pain) when initial radiographs are normal/effusion, show OCD/loose bodies or prior cartilage/meniscal repair, or internal derangement is suspected. Obtain radiographs first. Always confirm against the current Aetna policy.
How long does a Aetna prior authorization take?
Turnaround varies by plan and submission method. Check the Aetna portal for current timeframes.
Submitting MRI Lower Extremity Joint without contrast 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.