What insurance policy changes affect code M24.851?

There are 2 tracked policy changes affecting code M24.851, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code M24.851?

Payers that have issued tracked updates for code M24.851 include: Aetna.

How do I get notified when code M24.851 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code M24.851. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code M24.851?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

PAYER POLICY CHANGES

M24.851 Insurance Policy Changes

ICD-10 M24.851 is officially defined as "Other specific joint derangements of right hip, not elsewhere classified." code M24.851 is referenced in 2 tracked payer policy changes from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code M24.851 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Only a small number of policies match this filter. Check back as coverage expands.

Aetna · Identified Aug 16, 2026Medium impact
Hip Arthroplasty (CPB 0287, reviewed 2026-07-17)
Total hip arthroplasty is considered medically necessary for adult members when an FDA-approved implant is used and the member has advanced joint disease, meaning pain and functional disability that interferes with activities of daily living from osteoarthritis, rheumatoid arthritis, avascular necrosis or post-traumatic arthritis, along with limited range of motion, antalgic gait and radiographic evidence of avascular necrosis stage II or III or moderate/severe osteoarthritis or rheumatoid arthritis of the hip. Unsuccessful conservative therapy of 12 or 24 weeks, depending on age and BMI, must be clearly addressed in the medical record, with at least half consisting of formal in-person physical therapy in the past year. Revision or replacement of a total hip arthroplasty or hip resurfacing is covered when imaging confirms an indication such as aseptic loosening, component fracture or mechanical failure, periprosthetic infection, displaced periprosthetic fracture, progressive bone loss, bearing surface wear, recurrent dislocation or clinically significant leg length discrepancy. Computer-assisted navigation, custom joint implants, synovial CRP and alpha-defensin testing, obturator nerve blocks and portable accelerometer-based navigation are listed as experimental, investigational or unproven.
Aetna · Identified Aug 12, 2026Medium impact
Orthopedic Casts, Braces and Splints (CPB 0009, reviewed 2026-01-20)
Aetna considers orthoses, casts and splints medically necessary when they treat disease or injury for the listed indications, including lumbar and thoracic-lumbar-sacral braces that facilitate healing after a spine injury or spinal surgery, post-operative back braces applied within 6 weeks after spinal surgery, cervical braces for neck injury and torticollis, Unna boots for non-fracture care, air casts for fractures or other injuries, and prefabricated volar wrist braces for carpal tunnel syndrome. Prophylactic lumbar supports are considered experimental, investigational, or unproven, and elastic support garments and protective body socks do not meet Aetna's definition of covered durable medical equipment. Custom-fitted back braces are medically necessary where there is a failure, contraindication or intolerance to an unmodified, prefabricated back brace, and medical record documentation must support all coverage criteria because supplier-prepared statements and practitioner attestations alone are not sufficient.

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Hip Arthroplasty (CPB 0287, reviewed 2026-07-17)

Orthopedic Casts, Braces and Splints (CPB 0009, reviewed 2026-01-20)

What insurance policy changes affect code M24.851?

Which payers have updated policy for code M24.851?

How do I get notified when code M24.851 policy changes?

Why do payers change policies for code M24.851?