NY State Workers' Comp Knee Meniscectomy prior authorization requirements (2026)
What NY State Workers' Comp generally requires to approve Knee Meniscectomy (CPT 29880, 29881, 29882, 29883), for workers_comp plans. Based on the cited policy, NY State Workers' Comp does not generally require prior authorization for Knee Meniscectomy (CPT 29880, 29881, 29882, 29883). 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 Knee Injury MTG (meniscectomy/meniscus repair recommended for select patients with mechanical symptoms plus objective findings plus imaging plus a conservative-care trial). Not on the 324.3 always-PA list, so no separate PAR unless out-of-guideline or a repeat procedure — then file an MTG Variance via OnBoard.
Diagnoses that commonly support medical necessity
ICD-10-CM diagnoses frequently associated with medical necessity for Knee Meniscectomy. Confirm the covered diagnosis list against the current NY State Workers' Comp policy.
How to submit
- Method: OnBoard PAR
- Portal: NY WCB OnBoard
Sources & verification
- BindingSource — NY WCB Knee Injury 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 Knee Meniscectomy?
Based on the cited policy, NY State Workers' Comp does not generally require prior authorization for Knee Meniscectomy (CPT 29880, 29881, 29882, 29883). Confirm with NY State Workers' Comp, as this can vary by plan.
What does NY State Workers' Comp require to approve Knee Meniscectomy?
Authorized when consistent with the NY WC Knee Injury MTG (meniscectomy/meniscus repair recommended for select patients with mechanical symptoms plus objective findings plus imaging plus a conservative-care trial). Not on the 324.3 always-PA list, so no separate PAR unless out-of-guideline or a repeat procedure — then file an MTG Variance via OnBoard. 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 Knee Meniscectomy 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.