After a recent class action settlement Aetna has revised Clinical Policy Bulletin #0591 – Intervertebral Disc Prosthesis.  The review dated 2/8/2023 now allows for FDA approved total disc implant (CPT code 22857) for lumbar degenerative disc disease (ICD codes M51.36-M51.37) at one level.  The patient must meet certain criteria as listed in the policy.  Previously this procedure was considered experimental/investigational.  The policy can be found at

https://www.aetna.com/cpb/medical/data/500_599/0591.html

Doreen Clark, CPC, CPMA

Medical Auditing Division Manager