Draft — pending COA review. Rette derived these criteria from the ACOEM guidelines adopted into the MTUS. They are not COA documents and have not been signed off by a COA physician reviewer.

California Orthopaedic AssociationMTUS Treatment ChecklistbyRette

Utilization Review Checklist

Hip Fracture

Derived from the ACOEM Hip and Groin Disorders Guideline, edition 29 January 2026, as adopted into the California MTUS 1 August 2026. CPT 27235, 27236, 27244, 27245. ICD-10 S72.0, S72.1.

Draft — not reviewed or approved by COA. Prepared by Rette from the ACOEM guideline named above. This is not a COA document and does not reproduce COA’s own checklists.

Patient name: Claim #:

CriteriaCheck if documented

Confirmatory Diagnosis

Required

  • Hip fracture confirmed on imaging

    “Indications Hip fractures.” — p. 225

Surgical Considerations (surgical treatment)

All of the following

  • Surgery as soon as the patient is medically stable

    “Surgical intervention for hip fractures is recommended as soon as the patient is medically stable.” — p. 225

  • AND

    Procedure selected for the fracture pattern

    “Surgical intervention for hip fractures is recommended as soon as the patient is medically stable.” — p. 225

Procedures — the guideline treats each separately

Surgical treatment for hip fracture

Recommended.

Strength of Evidence — Recommended, Insufficient Evidence (I) · confidence high

The shortest indication in any of these chapters — the guideline's Indications field reads simply 'Hip fractures.' It recommends surgery AS SOON AS THE PATIENT IS MEDICALLY STABLE and records faster recovery and lower mortality than non-operative management. Confidence is High. There is no conservative requirement and delay is the thing to argue against, not for.

Reviewing this for COA, or think a criterion is wrong?