CurrentUnitedHealthcarePolicy CS342ID.A

Surgery of the Foot (for Idaho Only)

Clinical coverage policy for surgical procedures of the foot applicable only to the state of Idaho, including Idaho Medicaid Plus plans. It references InterQual criteria for specific procedures and defines medical necessity for hallux limitus/rigidus surgeries and osteochondral grafting.

Policy Summary

PayerUnitedHealthcare

PolicySurgery of the Foot (for Idaho Only)

Policy CodePolicy CS342ID.A

Change TypeNew policy

Effective DateJun 1, 2025

Next Review DateN/A

Key ActionDocument radiographic imaging confirming severity using an accepted grading scale and that reasonable trials of conservative therapies failed prior to surgery.

SourceLink

POLICY UPDATE CHANGES

New Medical Policy effective 2025-06-01 created for Surgery of the Foot (for Idaho Only).

1state-specific policy (Idaho)

6+CPT / procedure codes listed

InterQualExternal clinical criteria referenced

Osteochondral graftslisted as unproven / not medically necessary

Medical Necessity Criteria for Foot Surgery (Idaho)

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