TL;DR: Aetna, a CVS Health company, modified CPB 0853 governing wrist arthroplasty coverage, effective February 27, 2026. Here's what changes for billing teams.

This update to the Aetna wrist arthroplasty coverage policy tightens the line between covered and non-covered indications. CPT 25446 (total wrist arthroplasty) stays covered — but only for rheumatoid arthritis with a specific treatment failure history. Everything else, including osteoarthritis, post-traumatic arthritis, and a long list of specific devices and procedures, falls into experimental or non-covered territory. If your practice bills CPT 25446, CPT 1003T, or CPT 64772 for Aetna members, this policy directly affects your reimbursement and claim denial risk.


Quick-Reference Table

Field Detail
Payer Aetna, a CVS Health company
Policy Wrist Arthroplasty — CPB 0853
Policy Code CPB 0853
Change Type Modified
Effective Date February 27, 2026
Impact Level High
Specialties Affected Orthopedic surgery, hand surgery, rheumatology, ambulatory surgery centers
Key Action Audit all pending and future CPT 25446 claims to confirm the diagnosis is rheumatoid arthritis with documented NSAID/DMARD/glucocorticoid failure before billing Aetna

Aetna Wrist Arthroplasty Coverage Criteria and Medical Necessity Requirements 2026

The Aetna wrist arthroplasty coverage policy under CPB 0853 Aetna covers exactly one indication for total wrist arthroplasty: rheumatoid arthritis affecting the wrist.

That's it. One diagnosis, with three supporting requirements.

To meet medical necessity, the patient must have all of the following:

#Covered Indication
1Radiographic evidence of wrist joint destruction
2Diagnosed rheumatoid arthritis (ICD-10 range M05.00–M14.89)
3Documented treatment failure — at least three months of NSAIDs, disease-modifying anti-rheumatic drugs (DMARDs), and/or glucocorticoids, as clinically appropriate

All three criteria must appear in the medical record. Radiographic evidence alone isn't enough. A rheumatoid arthritis diagnosis alone isn't enough. You need the full picture documented before the claim goes out.

CPT 25446 — arthroplasty with prosthetic replacement of the distal radius and partial or entire carpus (total wrist) — is the primary procedure code for this coverage. CPT 1003T for arthroplasty of the first carpometacarpal joint with distal trapezial and proximal first metacarpal prosthesis also falls under this policy when selection criteria are met.

Prior authorization is almost certainly required for CPT 25446 on Aetna commercial plans. Confirm prior auth requirements with the specific plan before scheduling. Submitting without prior auth on a high-cost surgical procedure is a fast path to a claim denial you can't appeal on procedural grounds.

The medical necessity bar here is narrow by design. Aetna is drawing a hard line: rheumatoid arthritis with documented conservative treatment failure gets coverage. Everything else does not. This is not a policy that gives you wiggle room on diagnosis coding.


Aetna Wrist Arthroplasty Exclusions and Non-Covered Indications

This is where CPB 0853 gets detailed — and where most claim denial risk lives.

Aetna considers total wrist arthroplasty experimental, investigational, or unproven for the following diagnoses:

#Excluded Procedure
1Comminuted distal radius fracture (S52.591A–S52.599S)
2Kienbock's disease
3Osteoarthritis — primary, secondary, and post-traumatic (M19.131–M19.39)
+ 3 more exclusions

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If your surgeon performs CPT 25446 for any of these diagnoses, Aetna will not pay. Document everything you want about the clinical rationale — it won't change the coverage status. These are hard exclusions based on insufficient peer-reviewed evidence, not medical necessity disputes you can argue on appeal.

The policy also names specific devices and procedures as experimental or unproven, regardless of diagnosis:

#Excluded Procedure
1Integra Freedom Implant — experimental for all indications
2Pyrocarbon interposition arthroplasty for pisotriquetral arthritis (M13.811–M13.89) and scaphotrapeziotrapezoid osteoarthritis (M19.41–M19.49)
3Selective or complete denervation of the wrist/forearm for any pain diagnosis (M25.531–M25.539, R52) — billed under CPT 64772, which is explicitly not covered under this policy
+ 5 more exclusions

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The device list matters because surgeons sometimes select implants based on clinical preference or availability. If the implant your surgeon uses is on this list, the claim is denied — full stop — even if the diagnosis would otherwise qualify. Verify implant selection before surgery, not after.

CPT 64772 deserves special attention. Selective or complete wrist denervation is not covered under any diagnosis for any etiology. If your practice performs this procedure, do not bill it to Aetna expecting reimbursement. This is a line-item non-covered service under CPB 0853.


Coverage Indications at a Glance

Indication Coverage Status Relevant Codes Notes
Rheumatoid arthritis with radiographic joint destruction + ≥3 months conservative treatment failure Covered CPT 25446; M05.00–M14.89 All three criteria must be documented; prior auth required
First carpometacarpal joint arthroplasty (with prosthesis) Covered when criteria met CPT 1003T Selection criteria apply
Osteoarthritis (primary, secondary, post-traumatic) Experimental / Not Covered CPT 25446; M19.131–M19.39 No peer-reviewed evidence supports coverage
+ 12 more indications

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This policy is now in effect (since 2026-02-27). Verify your claims match the updated criteria above.

Aetna Wrist Arthroplasty Billing Guidelines and Action Items 2026

Here's what your billing team should do before and after the February 27, 2026 effective date.

#Action Item
1

Audit all queued CPT 25446 and CPT 1003T claims for Aetna before submission. Confirm the diagnosis code is within M05.00–M14.89 (rheumatoid arthritis). If the ICD-10 maps to osteoarthritis, post-traumatic arthritis, or any diagnosis on the exclusion list, do not submit — it will deny.

2

Verify prior authorization on every CPT 25446 case before scheduling. Call the Aetna plan directly or check the provider portal. Missing prior auth on a surgical procedure this high-value is a denial you won't recover from on appeal.

3

Confirm documentation of all three medical necessity criteria in the chart. Your coder needs to see: (a) a rheumatoid arthritis diagnosis, (b) imaging reports showing wrist joint destruction, and (c) documented failure of at least three months of NSAIDs, DMARDs, and/or glucocorticoids. Missing any one of these creates a medical necessity denial.

+ 4 more action items

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Sample Version Diff Line-by-line changes
Previous VersionCurrent Version
Coverage is considered experimental and investigational for all indicationsCoverage is considered medically necessary when specific criteria are met
Prior authorization is not requiredPrior authorization is required for initial treatment
Documentation must include clinical historyDocumentation must include clinical history
+ 1 more action items

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CPT, HCPCS, and ICD-10 Codes for Wrist Arthroplasty Under CPB 0853

Covered CPT Codes (When Selection Criteria Are Met)

Code Type Description
1003T CPT Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthesis
25446 CPT Arthroplasty with prosthetic replacement; distal radius and partial or entire carpus (total wrist)

Not Covered / Experimental Codes

Code Type Description Reason
64772 CPT Transection or avulsion of other spinal nerve, extradural (selective or complete denervation in the wrist/forearm) Not covered for any diagnosis of wrist/forearm pain regardless of etiology

Key ICD-10-CM Diagnosis Codes

Code Description
M05.00–M14.89 Rheumatoid arthritis (covered indication)
M12.531–M12.539 Traumatic arthropathy, wrist (scapholunate advanced collapse — not covered)
M13.811–M13.89 Other specified arthritis — pisotriquetral arthritis (not covered)
+ 11 more codes

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