Does Cigna require prior authorization for CPT 27447?

Yes. Cigna requires prior authorization for CPT 27447 (Total knee arthroplasty) under commercial plans in TX per its published clinical policy.

What documentation does Cigna require for CPT 27447?

Clinical notes supporting medical necessity; Relevant diagnostic, imaging, lab, or treatment records for the requested service

How long does Cigna take to respond to a PA request?

Standard Cigna commercial PA determinations are returned within 5–14 business days for non-urgent requests and 72 hours for urgent (expedited) requests, per state-regulated and contractual timelines.

What if Cigna denies the PA for CPT 27447?

Appeal in writing within 60 days, citing the specific clinical policy criteria the case meets and attaching supporting documentation. Many denials are reversed on first-level appeal when the criteria language is mirrored.

Prior Authorization

Cigna Prior Authorization for CPT 27447

Total knee arthroplasty · TX · commercial plans

Prior authorization REQUIREDVerified 2026-05-09 · Cigna

Source

Cigna Commercial Joint Surgery Code List - Effective 03/07/2026

Not medical advice. PA policies change frequently. Always confirm against the payer's current policy before submitting. d3rx pulls directly from publicly published policy PDFs and refreshes daily.

Clinical criteria

Cigna/EviCore Cigna Commercial Joint Surgery Code List - Effective 03/07/2026 lists 27447 as requiring prior authorization for commercial plans, effective 2026-03-07. Confirm member benefit, plan model, and delegated workflow before submission.

Documentation checklist

✓Clinical notes supporting medical necessity
✓Relevant diagnostic, imaging, lab, or treatment records for the requested service

How to submit the PA

1Verify the requirement against the current clinical policy PDF linked above.
2Gather documentation: Clinical notes supporting medical necessity, Relevant diagnostic, imaging, lab, or treatment records for the requested service.
3Submit via the payer's provider portal or designated PA channel.
4Document the reference number and follow up within 5 business days if no determination is received.

FAQ

Does Cigna require prior authorization for CPT 27447?: Yes. Cigna requires prior authorization for CPT 27447 (Total knee arthroplasty) under commercial plans in TX per its published clinical policy.
What documentation does Cigna require for CPT 27447?: Clinical notes supporting medical necessity; Relevant diagnostic, imaging, lab, or treatment records for the requested service
How long does Cigna take to respond to a PA request?: Standard Cigna commercial PA determinations are returned within 5–14 business days for non-urgent requests and 72 hours for urgent (expedited) requests, per state-regulated and contractual timelines.
What if Cigna denies the PA for CPT 27447?: Appeal in writing within 60 days, citing the specific clinical policy criteria the case meets and attaching supporting documentation. Many denials are reversed on first-level appeal when the criteria language is mirrored.

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