Highmark BCBS Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair prior authorization requirements (2026)

What Highmark 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. Highmark BCBS generally requires prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair (CPT 29914, 29915, 29916, 29860, 29861, 29862, 29863).

General reference compiled from public sources. This is not a coverage determination or medical advice. Always confirm current requirements with Highmark BCBS before submitting.

Medical-necessity criteria Highmark BCBS generally applies

(1) MRI/MR arthrogram confirming FAI with labral pathology; (2) Alpha angle >55° or CE angle >40°; (3) Symptoms ≥3 months, positive FADIR; (4) PT failure ≥3 months (≥8 hip-specific sessions); (5) Tönnis ≤1; (6) HOS or iHOT-33 in severe range

Commonly required documentation

  • MRI with alpha angle
  • PT records
  • HOS/iHOT score
  • pelvis/hip X-rays
  • surgeon evaluation

How to submit

Sources & verification

  • BindingSource — Hip Surgery: Femoroacetabular Impingement (FAI) — Highmark MSK program (Feb 2026 Medical Policy Update) (S-316) · effective 2026-05-01.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.

Frequently asked questions

Does Highmark BCBS require prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair?

Yes. Highmark 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 Highmark BCBS require to approve Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair?

(1) MRI/MR arthrogram confirming FAI with labral pathology; (2) Alpha angle >55° or CE angle >40°; (3) Symptoms ≥3 months, positive FADIR; (4) PT failure ≥3 months (≥8 hip-specific sessions); (5) Tönnis ≤1; (6) HOS or iHOT-33 in severe range Always confirm against the current Highmark BCBS policy.

How long does a Highmark BCBS prior authorization take?

Highmark BCBS typically decides Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair requests in about 3 days. Timeframes vary; check the payer portal.

Submitting Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair to Highmark 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.

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Other Highmark BCBS prior authorization requirements

Anterior Cervical Discectomy and FusionCarpal Tunnel SurgeryDorsal Column (Lumbar) Neurostimulators: Trial or ImplantationKnee ArthroscopyLumbar Spinal FusionOutpatient Physical TherapyPain Injections - SpineShoulder Arthroscopy Rotator Cuff RepairTotal Knee ArthroplastyVertebroplasty/Kyphoplasty

Related guides

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