Anthem/Elevance Health Total Shoulder Arthroplasty prior authorization requirements (2026)

What Anthem/Elevance Health generally requires to approve Total Shoulder Arthroplasty (CPT 23472), for Commercial plans. Yes. Anthem/Elevance Health generally requires prior authorization for Total Shoulder Arthroplasty (CPT 23472).

General reference compiled from public sources. This is not a coverage determination or medical advice. Always confirm current requirements with Anthem/Elevance Health before submitting.

Medical-necessity criteria Anthem/Elevance Health generally applies

(1) Severe glenohumeral arthritis on X-ray; (2) Conservative care failure ≥3 months; (3) ASES <50 AND forward elevation <120°; (4) Anatomic: intact/reparable cuff; Reverse: massive irreparable cuff with intact deltoid; (5) CT if significant glenoid bone loss

Diagnoses that commonly support medical necessity

ICD-10-CM diagnoses frequently associated with medical necessity for Total Shoulder Arthroplasty. Confirm the covered diagnosis list against the current Anthem/Elevance Health policy.

M19.011Primary osteoarthritis, right shoulderM19.012Primary osteoarthritis, left shoulderM19.019Primary osteoarthritis, unspecified shoulder

Commonly required documentation

  • Shoulder X-rays
  • MRI
  • ASES score and ROM
  • conservative care records
  • surgeon implant selection rationale

How to submit

Source

Specify implant type — anatomic vs. reverse has distinct criteria. Bone loss patterns (Walch type B2+) may require CT glenoid for implant planning.

Frequently asked questions

Does Anthem/Elevance Health require prior authorization for Total Shoulder Arthroplasty?

Yes. Anthem/Elevance Health generally requires prior authorization for Total Shoulder Arthroplasty (CPT 23472).

What does Anthem/Elevance Health require to approve Total Shoulder Arthroplasty?

(1) Severe glenohumeral arthritis on X-ray; (2) Conservative care failure ≥3 months; (3) ASES <50 AND forward elevation <120°; (4) Anatomic: intact/reparable cuff; Reverse: massive irreparable cuff with intact deltoid; (5) CT if significant glenoid bone loss Always confirm against the current Anthem/Elevance Health policy.

How long does a Anthem/Elevance Health prior authorization take?

Anthem/Elevance Health typically decides Total Shoulder Arthroplasty requests in about 3 days. Timeframes vary; check the payer portal.

Submitting Total Shoulder Arthroplasty to Anthem/Elevance Health?

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 Anthem/Elevance Health prior authorization requirements

Anterior Cervical Discectomy and FusionArthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairCarpal Tunnel SurgeryCT Abdomen and Pelvis with contrastCTA Chest (e.g., pulmonary embolism)Dorsal Column (Lumbar) Neurostimulators: Trial or ImplantationKnee ArthroscopyKnee MeniscectomyLumbar Spinal FusionMRI Brain without contrastMRI Cervical Spine without contrastMRI Lower Extremity Joint without contrast

Related guides

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