Historical (last reviewed 02/25/2026): Aetna considers total wrist arthroplasty medically necessary only for rheumatoid arthritis affecting the wrist, in persons with radiographic evidence of wrist joint destruction and demonstrated resistance or failure to conservative medical treatment of at least 3 months with NSAIDs, DMARDs, and/or glucocorticoids, as appropriate. Total wrist arthroplasty is considered experimental, investigational, or unproven for other diagnoses, including comminuted distal radius fracture, Kienbock's disease, osteoarthritis, post-traumatic arthritis, scaphoid non-union, and scapholunate dissociation. Wrist hemiarthroplasty, selective or complete wrist denervation, the Integra Freedom implant, the Prosthelast, the Universal 2 system, and the Motec and ReMotion prostheses for non-rheumatoid wrist arthritis are also considered experimental, investigational, or unproven.
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01Billing team: Claims for CPT 25446 need documentation of rheumatoid arthritis affecting the wrist, radiographic evidence of wrist joint destruction, and at least 3 months of conservative treatment with NSAIDs, DMARDs, and/or glucocorticoids, as appropriate.
02CPT 1003T is listed as covered if selection criteria are met.
03CPT 64772 for selective or complete denervation in the wrist or forearm is listed as not covered.
04Total wrist arthroplasty for other diagnoses, such as Kienbock's disease, osteoarthritis, or scaphoid non-union, is not covered under this policy.
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