NY State Workers' Comp Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair prior authorization requirements (2026)
What NY State Workers' Comp generally requires to approve Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair (CPT 29914, 29915, 29916, 29860, 29861, 29862, 29863), for workers_comp plans. Based on the cited policy, NY State Workers' Comp does not generally require prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair (CPT 29914, 29915, 29916, 29860, 29861, 29862, 29863). Confirm with NY State Workers' Comp, as this can vary by plan.
Medical-necessity criteria NY State Workers' Comp generally applies
Authorized when consistent with the NY WC Hip and Groin Disorders MTG — hip arthroscopy recommended for FAI / labral tear / intra-articular body with mechanical symptoms that failed conservative care, supported by a positive impingement test (pain with passive adduction plus internal rotation of the flexed hip), decreased internal rotation/adduction at 90-degree flexion, and MR arthrogram. Not on the 324.3 always-PA list; PA only for repeat/second procedures or out-of-guideline (MTG Variance via OnBoard).
How to submit
- Method: OnBoard PAR
- Portal: NY WCB OnBoard
Sources & verification
- BindingSource — NY WCB Hip and Groin Disorders Medical Treatment Guidelines · effective 2022-05-02.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 NY State Workers' Comp require prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair?
Based on the cited policy, NY State Workers' Comp does not generally require prior authorization for Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair (CPT 29914, 29915, 29916, 29860, 29861, 29862, 29863). Confirm with NY State Workers' Comp, as this can vary by plan.
What does NY State Workers' Comp require to approve Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair?
Authorized when consistent with the NY WC Hip and Groin Disorders MTG — hip arthroscopy recommended for FAI / labral tear / intra-articular body with mechanical symptoms that failed conservative care, supported by a positive impingement test (pain with passive adduction plus internal rotation of the flexed hip), decreased internal rotation/adduction at 90-degree flexion, and MR arthrogram. Not on … Always confirm against the current NY State Workers' Comp policy.
How long does a NY State Workers' Comp prior authorization take?
Turnaround varies by plan and submission method. Check the NY State Workers' Comp portal for current timeframes.
Submitting Arthroscopic Hip Surgery for Impingement Syndrome Including Labral Repair to NY State Workers' Comp?
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.