Does S2900 require prior authorization?

No, S2900 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for S2900?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

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`S2900`, Surgical techniques requiring use of robotic surgical system (list separately

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

Use of intra-operative/intra-wound vancomycin powder: document dosing/administration, indication, baseline infection risk factors, and post-operative monitoring for wound complications, AKI, ototoxicity (authors reported no statistical difference but monitored these endpoints).
When using TXA: documentation of procedure type (primary THA), route and dosing of TXA (intravenous, topical, or combined), and exclusion/consideration if revision THA or hip fracture surgery (VHA: evidence lacking in revisions/hip fracture).

Robotic or navigation-assisted THA: pre-operative target angles, intra-operative navigation records (intra-operative cup angles using navigation records), and post-operative imaging to verify cup orientation (post-operative CT data or radiographs) as used in the cited studies (e.g., HipAlign intra-op records vs post-op CT comparisons).

For diagnosis and management of iliopsoas impingement: documentation of careful history, physical examination, laboratory evaluation, diagnostic imaging (X-rays and pelvic CT scans), and diagnostic local anesthetic/infiltration test results prior to performing tenotomy; if tenotomy performed, document site (lesser trochanter or acetabular rim), technique, and pre- and post-operative PROs (HHS, WOMAC, Oxford Hip Score, mHHS) where available.

For custom-made acetabular implants: documentation of Paprosky classification of acetabular deficiency (e.g., Type IIIA/IIIB), CT-based pre-operative planning, rationale for custom implant, and post-operative radiographic/CT assessment of implant position and fixation.

For thromboprophylaxis decisions: documentation of chosen agent and regimen (aspirin, LMWH, enoxaparin, rivaroxaban), indications and contraindications, and informed discussion reflecting current evidence (e.g., CRISTAL results favoring enoxaparin over aspirin for symptomatic VTE prevention).

Key Coverage Criteria

Removable oral appliances are proven and medically necessary for treating obstructive sleep apnea (OSA) when a sleep study confirms diagnosis and prior evaluation has occurred.
Progressive or substantial periprosthetic bone loss confirmed by imaging;
Outside-in arthroscopic psoas release for anterior iliopsoas impingement after primary total hip arthroplasty
Fracture or mechanical failure of 1 or more components of the prosthesis confirmed by imaging;
Confirmed periprosthetic infection confirmed by gram stain and culture;
Displaced periprosthetic fracture confirmed by imaging;

8 Active Policies

CGS-J15-L40232, Total Joint Arthroplasty

J15

CGS-J18-L40232, Total Joint Arthroplasty

J18

UHC-POL-obstructive-sleep-apnea-treatment, Obstructive and Central Sleep Apnea Treatment

AETNA-CPB-0287, Hip Arthroplasty

AETNA-CPB-0660, Knee Arthroplasty

UMR-POL-UMR-obstructive-sleep-apnea-treatment, Obstructive and Central Sleep Apnea Treatment

A60250, Billing and Coding: Total Joint Arthroplasty

SUREST-POL-SUREST-obstructive-sleep-apnea-treatment-sur, Obstructive and Central Sleep Apnea Treatment – Surest Medical Policy

`S2900`, Surgical techniques requiring use of robotic surgical system (list separately

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

8 Active Policies

Related Codes

Have a follow-up question?

S2900, Surgical techniques requiring use of robotic surgical system (list separately

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

8 Active Policies

Related Codes

Have a follow-up question?

`S2900`, Surgical techniques requiring use of robotic surgical system (list separately