High impact
Knee Arthroplasty (CPB 0660, reviewed 2026-02-26)
Aetna·Effective Feb 26, 2026
Aetna has updated its Clinical Policy Bulletin 0660 for knee arthroplasty procedures, effective immediately. This policy establishes comprehensive medical necessity criteria for total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), and revision procedures, including specific requirements for conservative therapy documentation, physical therapy evidence, and contraindication screening. Billing teams must ensure all knee arthroplasty claims include complete documentation of radiographic findings (Kellgren-Lawrence grading), at least 12-24 weeks of conservative therapy with formal PT notes, and verification that absolute contraindications are absent.