Aetna Vertebroplasty/Kyphoplasty prior authorization requirements (2026)
What Aetna generally requires to approve Vertebroplasty/Kyphoplasty (CPT 22510, 22511, 22512, 22513, 22514, 22515), for Commercial plans. Yes. Aetna generally requires prior authorization for Vertebroplasty/Kyphoplasty (CPT 22510, 22511, 22512, 22513, 22514, 22515).
Medical-necessity criteria Aetna generally applies
Medical necessity review required
Diagnoses that commonly support medical necessity
ICD-10-CM diagnoses frequently associated with medical necessity for Vertebroplasty/Kyphoplasty. 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
Precertification required for all applicable plans Last verified 2026-05-06.
Frequently asked questions
Does Aetna require prior authorization for Vertebroplasty/Kyphoplasty?
Yes. Aetna generally requires prior authorization for Vertebroplasty/Kyphoplasty (CPT 22510, 22511, 22512, 22513, 22514, 22515).
What does Aetna require to approve Vertebroplasty/Kyphoplasty?
Medical necessity review required Always confirm against the current Aetna policy.
How long does a Aetna prior authorization take?
Aetna typically decides Vertebroplasty/Kyphoplasty requests in about 3 days. Timeframes vary; check the payer portal.
Submitting Vertebroplasty/Kyphoplasty 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.