Horizon BCBS NJ ACL Reconstruction prior authorization requirements (2026)

What Horizon BCBS NJ generally requires to approve ACL Reconstruction (CPT 29888, 29889), for PPO plans. Yes. Horizon BCBS NJ generally requires prior authorization for ACL Reconstruction (CPT 29888, 29889).

General reference compiled from public sources, last verified 2026-06-18. This is not a coverage determination or medical advice. Always confirm current requirements with Horizon BCBS NJ before submitting.

Medical-necessity criteria Horizon BCBS NJ generally applies

Prior authorization required; managed by TurningPoint Healthcare Solutions under policy OR-1013 (ACL Repair/Reconstruction). Medical necessity generally requires ALL of: no advanced knee arthritis (not Kellgren-Lawrence grade 4); a documented ACL tear established by exam (positive Lachman, anterior drawer, or pivot-shift) OR by MRI/CT; and EITHER an ACL tear occurring with a concurrent meniscal or ligamentous injury (MCL, PCL, or posterolateral corner) OR failure of at least 2 weeks of conservative treatment.

Diagnoses that commonly support medical necessity

ICD-10-CM diagnoses frequently associated with medical necessity for ACL Reconstruction. Confirm the covered diagnosis list against the current Horizon BCBS NJ policy.

S83.519ASprain of anterior cruciate ligament of unspecified knee, initial encounterM23.619Other spontaneous disruption of anterior cruciate ligament of unspecified knee

Related procedure codes

Codes often billed alongside ACL Reconstruction: 27407, 27409. Verify the correct codes for your documentation.

Commonly required documentation

  • MRI/CT report or documented instability exam (Lachman, anterior drawer, or pivot-shift)
  • documentation of any concurrent meniscal/ligamentous injury or of a conservative trial of at least 2 weeks

Situations to verify before submitting

Horizon BCBS NJ may not cover ACL Reconstruction in these situations. Verify against the current policy rather than assuming a denial:

  • Advanced knee osteoarthritis (Kellgren-Lawrence grade 4)
  • Asymptomatic or incidental ACL findings without instability or functional deficit

How to submit

Source

PA confirmed required and managed by TurningPoint (Horizon Surgical & Implantable Device Management Program). Code-to-policy mapping (29888 -> OR-1013) verified from TurningPoint MSK crosswalk: . Exact OR-1013 criteria via TurningPoint (1-833-436-4083); framework references public Carelon Joint Surgery MSK02-1125.1 ACL section. View the source policy. Last verified 2026-06-18.

Frequently asked questions

Does Horizon BCBS NJ require prior authorization for ACL Reconstruction?

Yes. Horizon BCBS NJ generally requires prior authorization for ACL Reconstruction (CPT 29888, 29889).

What does Horizon BCBS NJ require to approve ACL Reconstruction?

Prior authorization required; managed by TurningPoint Healthcare Solutions under policy OR-1013 (ACL Repair/Reconstruction). Medical necessity generally requires ALL of: no advanced knee arthritis (not Kellgren-Lawrence grade 4); a documented ACL tear established by exam (positive Lachman, anterior drawer, or pivot-shift) OR by MRI/CT; and EITHER an ACL tear occurring with a concurrent meniscal or… Always confirm against the current Horizon BCBS NJ policy.

How long does a Horizon BCBS NJ prior authorization take?

Turnaround varies by plan and submission method. Check the Horizon BCBS NJ portal for current timeframes.

Submitting ACL Reconstruction to Horizon BCBS NJ?

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 Horizon BCBS NJ prior authorization requirements

Anterior Cervical Discectomy and FusionCarpal Tunnel SurgeryCervical, Lumbar and Thoracic Laminectomy and/or Laminotomy ProceduresKnee ArthroscopyKnee MeniscectomyLumbar Spinal FusionShoulder Arthroplasty Including Revision ProceduresShoulder Arthroscopy Rotator Cuff RepairTotal Knee ArthroplastyTotal Shoulder 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