Aetna Shoulder Arthroplasty Including Revision Procedures prior authorization requirements (2026)
What Aetna generally requires to approve Shoulder Arthroplasty Including Revision Procedures (CPT 23470, 23472, 23473, 23474), for Commercial plans. Yes. Aetna generally requires prior authorization for Shoulder Arthroplasty Including Revision Procedures (CPT 23470, 23472, 23473, 23474).
Medical-necessity criteria Aetna generally applies
CPT codes 23470, 23472, 23473 subject to medical necessity review of procedure and site of service for Commercial members
Diagnoses that commonly support medical necessity
ICD-10-CM diagnoses frequently associated with medical necessity for Shoulder Arthroplasty Including Revision Procedures. Confirm the covered diagnosis list against the current Aetna policy.
Commonly required documentation
- All medical records requested must be submitted
How to submit
- Method: portal
- Typical turnaround: about 3 days
Source
Some codes marked as elective procedures for Commercial members Last verified 2026-05-06.
Frequently asked questions
Does Aetna require prior authorization for Shoulder Arthroplasty Including Revision Procedures?
Yes. Aetna generally requires prior authorization for Shoulder Arthroplasty Including Revision Procedures (CPT 23470, 23472, 23473, 23474).
What does Aetna require to approve Shoulder Arthroplasty Including Revision Procedures?
CPT codes 23470, 23472, 23473 subject to medical necessity review of procedure and site of service for Commercial members Always confirm against the current Aetna policy.
How long does a Aetna prior authorization take?
Aetna typically decides Shoulder Arthroplasty Including Revision Procedures requests in about 3 days. Timeframes vary; check the payer portal.
Submitting Shoulder Arthroplasty Including Revision Procedures 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.