CPT 14061, in plain terms, covers Rearrangement of adjacent skin, such as a local flap, to close a defect on the eyelid, nose, ear, or lip, with the defect measuring 10.1 to 30.0 square centimeters. CPT 14061 is referenced in 5 tracked payer policy changes from Blue Cross Blue Shield of Nebraska and Independence Blue Cross. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 14061 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Official descriptor: CPT 14061 on AAPC
Blue Cross Blue Shield of Nebraska is implementing a new medical policy requiring preauthorization for all tissue transfer (flap) procedures starting May 1, 2026. The policy covers 33 specific CPT codes and will use Interqual criteria for approval decisions.
Blue Cross and Blue Shield of Nebraska is implementing a new medical policy (III.274) for tissue transfer (flap) procedures effective May 1, 2026. Starting that date, preauthorization will be required for all tissue transfer flap procedures, and Interqual Criteria will be used for clinical review. The policy affects 24 specific CPT codes related to various flap procedures across multiple anatomical locations.
Independence Blue Cross reissued policy 11.01.01j on 09/02/2026 to communicate their continuing position on otoplasty and non-surgical external ear molding. The policy clarifies coverage criteria distinguishing between medically necessary reconstructive procedures (for trauma, disease, congenital deformities with functional hearing impairment) and cosmetic procedures (which are excluded). Non-surgical ear molding devices are covered only when congenital malformations cause significant functional hearing impairment with diagnostic testing evidence.
This is a reissue with no substantive changes to MA11.058a policy on otoplasty and non-surgical external ear molding. The policy was reissued on 09/02/2026 as part of Independence Blue Cross's annual review process. All coverage criteria, billing codes, and medical necessity requirements remain unchanged from the 01/01/2024 effective version.
This is a reissue of Independence Blue Cross policy 11.01.01j confirming the company's continuing position on otoplasty and non-surgical external ear molding coverage. The policy establishes clear medical necessity criteria for coverage (trauma, disease/tumors causing functional hearing impairment, congenital deformities) and explicitly excludes cosmetic procedures. No substantive changes to coverage criteria, codes, or requirements were made in this reissue.
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