Aetna Orthognathic Surgery Procedures, Bone Grafts, Osteotomies and TMJ Management prior authorization requirements (2026)
What Aetna generally requires to approve Orthognathic Surgery Procedures, Bone Grafts, Osteotomies and TMJ Management (CPT 21010, 21050, 21060, 21070, 21073, 21120, 21121, 21122, 21123, 21125, 21127, 21141, 21142, 21143, 21145, 21146, 21147, 21150, 21151, 21154, 21159, 21193, 21194, 21195, 21196, 21198, 21199, 21206, 21208, 21209, 21210, 21215, 21240, 21242, 21243, 21244, 21247, 21255, 21480, 21485, 21490, 21497, 29800, 29804), for Commercial plans. Yes. Aetna generally requires prior authorization for Orthognathic Surgery Procedures, Bone Grafts, Osteotomies and TMJ Management (CPT 21010, 21050, 21060, 21070, 21073, 21120, 21121, 21122, 21123, 21125, 21127, 21141, 21142, 21143, 21145, 21146, 21147, 21150, 21151, 21154, 21159, 21193, 21194, 21195, 21196, 21198, 21199, 21206, 21208, 21209, 21210, 21215, 21240, 21242, 21243, 21244, 21247, 21255, 21480, 21485, 21490, 21497, 29800, 29804).
Medical-necessity criteria Aetna generally applies
Medical necessity review required
Commonly required documentation
- Complete medical records submission
How to submit
- Method: portal
- Typical turnaround: about 3 days
Source
Includes temporomandibular joint surgical management Last verified 2026-05-06.
Frequently asked questions
Does Aetna require prior authorization for Orthognathic Surgery Procedures, Bone Grafts, Osteotomies and TMJ Management?
Yes. Aetna generally requires prior authorization for Orthognathic Surgery Procedures, Bone Grafts, Osteotomies and TMJ Management (CPT 21010, 21050, 21060, 21070, 21073, 21120, 21121, 21122, 21123, 21125, 21127, 21141, 21142, 21143, 21145, 21146, 21147, 21150, 21151, 21154, 21159, 21193, 21194, 21195, 21196, 21198, 21199, 21206, 21208, 21209, 21210, 21215, 21240, 21242, 21243, 21244, 21247, 21255, 21480, 21485, 21490, 21497, 29800, 29804).
What does Aetna require to approve Orthognathic Surgery Procedures, Bone Grafts, Osteotomies and TMJ Management?
Medical necessity review required Always confirm against the current Aetna policy.
How long does a Aetna prior authorization take?
Aetna typically decides Orthognathic Surgery Procedures, Bone Grafts, Osteotomies and TMJ Management requests in about 3 days. Timeframes vary; check the payer portal.
Submitting Orthognathic Surgery Procedures, Bone Grafts, Osteotomies and TMJ Management 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.