Aetna Osteochondral Allograft/Knee prior authorization requirements (2026)

What Aetna generally requires to approve Osteochondral Allograft/Knee (CPT 27415), for Commercial plans. Yes. Aetna generally requires prior authorization for Osteochondral Allograft/Knee (CPT 27415).

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

For Commercial members, subject to medical necessity review of procedure and site of service

Diagnoses that commonly support medical necessity

ICD-10-CM diagnoses frequently associated with medical necessity for Osteochondral Allograft/Knee. Confirm the covered diagnosis list against the current Aetna policy.

M24.169Other articular cartilage disorders, unspecified knee

Commonly required documentation

  • All medical records requested must be submitted

How to submit

  • Method: portal
  • Typical turnaround: about 3 days

Source

Elective procedure for Commercial members Last verified 2026-05-06.

Frequently asked questions

Does Aetna require prior authorization for Osteochondral Allograft/Knee?

Yes. Aetna generally requires prior authorization for Osteochondral Allograft/Knee (CPT 27415).

What does Aetna require to approve Osteochondral Allograft/Knee?

For Commercial members, subject to medical necessity review of procedure and site of service Always confirm against the current Aetna policy.

How long does a Aetna prior authorization take?

Aetna typically decides Osteochondral Allograft/Knee requests in about 3 days. Timeframes vary; check the payer portal.

Submitting Osteochondral Allograft/Knee 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)Artificial Intervertebral Disc Surgery (Lumbar 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)

Related guides

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