Cigna Total Ankle Arthroplasty prior authorization requirements (2026)
What Cigna generally requires to approve Total Ankle Arthroplasty (CPT 27702), for Commercial plans. Yes. Cigna generally requires prior authorization for Total Ankle Arthroplasty (CPT 27702).
Medical-necessity criteria Cigna generally applies
Total ankle arthroplasty with an FDA-approved/cleared device is covered as an alternative to ankle arthrodesis for end-stage ankle arthritis when conservative management has failed (generally at least 6 months). The historically suggested candidate profile is age 50 or older, BMI under 30, and low-demand physical activity. Revision total ankle arthroplasty is addressed under a separate not-medically-necessary statement.
Diagnoses that commonly support medical necessity
ICD-10-CM diagnoses frequently associated with medical necessity for Total Ankle Arthroplasty. Confirm the covered diagnosis list against the current Cigna policy.
Source
Source: Cigna Medical Coverage Policy 0285 Total Ankle Arthroplasty/Replacement (static.cigna.com coveragePolicies/medical/mm_0285_coveragepositioncriteria_total_ankle_arthroplasty.pdf). Last verified 2026-06-11.
Frequently asked questions
Does Cigna require prior authorization for Total Ankle Arthroplasty?
Yes. Cigna generally requires prior authorization for Total Ankle Arthroplasty (CPT 27702).
What does Cigna require to approve Total Ankle Arthroplasty?
Total ankle arthroplasty with an FDA-approved/cleared device is covered as an alternative to ankle arthrodesis for end-stage ankle arthritis when conservative management has failed (generally at least 6 months). The historically suggested candidate profile is age 50 or older, BMI under 30, and low-demand physical activity. Revision total ankle arthroplasty is addressed under a separate not-medical… Always confirm against the current Cigna policy.
How long does a Cigna prior authorization take?
Turnaround varies by plan and submission method. Check the Cigna portal for current timeframes.
Submitting Total Ankle Arthroplasty to Cigna?
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.