Aetna Plantar Fasciotomy (Plantar Fasciitis Surgery) prior authorization requirements (2026)
What Aetna generally requires to approve Plantar Fasciotomy (Plantar Fasciitis Surgery) (CPT 29893, 20550). Yes. Aetna generally requires prior authorization for Plantar Fasciotomy (Plantar Fasciitis Surgery) (CPT 29893, 20550).
Medical-necessity criteria Aetna generally applies
Endoscopic plantar fasciotomy (CPT 29893) is medically necessary as an alternative to conventional open plantar fasciotomy for members with intractable plantar fasciitis or heel spur syndrome who have failed a 6-month trial of conservative therapy. A combined steroid/anesthetic injection (CPT 20550) is medically necessary when conservative treatments (stretching exercises, over-the-counter silicone heel inserts, and 2 to 3 weeks of NSAIDs) have failed.
Diagnoses that commonly support medical necessity
ICD-10-CM diagnoses frequently associated with medical necessity for Plantar Fasciotomy (Plantar Fasciitis Surgery). Confirm the covered diagnosis list against the current Aetna policy.
Commonly required documentation
- Diagnosis of plantar fasciitis or heel spur syndrome
- documentation of a 6-month trial of conservative therapy (for fasciotomy) or of failed conservative treatment (for injection).
Situations to verify before submitting
Aetna may not cover Plantar Fasciotomy (Plantar Fasciitis Surgery) in these situations. Verify against the current policy rather than assuming a denial:
- Extracorporeal shock-wave therapy (all devices) is considered experimental/not medically necessary for plantar fasciitis.
- Experimental adjuncts include PRP injections, botulinum toxin, cryotherapy, dry needling, radiofrequency lesioning, low-level/high-intensity laser, ultrasound therapy, acupuncture, and gastrocnemius lengthening.
Source
Source: Aetna Clinical Policy Bulletin 0235, Plantar Fasciitis Treatments (). View the source policy. Last verified 2026-06-16.
Frequently asked questions
Does Aetna require prior authorization for Plantar Fasciotomy (Plantar Fasciitis Surgery)?
Yes. Aetna generally requires prior authorization for Plantar Fasciotomy (Plantar Fasciitis Surgery) (CPT 29893, 20550).
What does Aetna require to approve Plantar Fasciotomy (Plantar Fasciitis Surgery)?
Endoscopic plantar fasciotomy (CPT 29893) is medically necessary as an alternative to conventional open plantar fasciotomy for members with intractable plantar fasciitis or heel spur syndrome who have failed a 6-month trial of conservative therapy. A combined steroid/anesthetic injection (CPT 20550) is medically necessary when conservative treatments (stretching exercises, over-the-counter silicon… 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 Plantar Fasciotomy (Plantar Fasciitis Surgery) 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.