AIM (out-of-state / Federal BCBS) Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair prior authorization requirements (2026)
What AIM (out-of-state / Federal BCBS) generally requires to approve Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair (CPT 29914, 29915, 29916, 29860, 29861, 29862, 29863), for commercial plans. Yes. AIM (out-of-state / Federal BCBS) generally requires prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair (CPT 29914, 29915, 29916, 29860, 29861, 29862, 29863).
Medical-necessity criteria AIM (out-of-state / Federal BCBS) generally applies
Prior authorization via Carelon (Joint Surgery MSK02-1125.1). Femoroplasty for FAI syndrome requires an alpha angle over 55 degrees; hip arthroscopy for labral repair is excluded in untreated severe hip dysplasia. (Broader exam/imaging/conservative-care detail per the full guideline — confirm in the Carelon portal.)
How to submit
- Method: Carelon ProviderPortal
- Portal: Carelon Medical Benefits Management
Sources & verification
- BindingSource — Carelon Clinical Appropriateness Guidelines — Joint Surgery (MSK02-1125.1) · effective 2025-11-15.View
Binding = the payer's own policy. Proxy = a public, evidence-based clinical guideline the payer mirrors. Portal-only = the binding criteria are confirmed in the administrator's portal. Always confirm against the payer for the member's specific plan. Last verified 2026-06-26.
Frequently asked questions
Does AIM (out-of-state / Federal BCBS) require prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair?
Yes. AIM (out-of-state / Federal BCBS) generally requires prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair (CPT 29914, 29915, 29916, 29860, 29861, 29862, 29863).
What does AIM (out-of-state / Federal BCBS) require to approve Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair?
Prior authorization via Carelon (Joint Surgery MSK02-1125.1). Femoroplasty for FAI syndrome requires an alpha angle over 55 degrees; hip arthroscopy for labral repair is excluded in untreated severe hip dysplasia. (Broader exam/imaging/conservative-care detail per the full guideline — confirm in the Carelon portal.) Always confirm against the current AIM (out-of-state / Federal BCBS) policy.
How long does a AIM (out-of-state / Federal BCBS) prior authorization take?
Turnaround varies by plan and submission method. Check the AIM (out-of-state / Federal BCBS) portal for current timeframes.
Submitting Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair to AIM (out-of-state / Federal BCBS)?
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.