What insurance policy changes affect CPT 19328?

There are 8 tracked policy changes affecting CPT 19328, including updates from Arkansas Blue Cross Blue Shield, Capital Blue Cross, Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 19328?

Payers that have issued tracked updates for CPT 19328 include: Arkansas Blue Cross Blue Shield, Capital Blue Cross, Humana, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 19328 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 19328. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 19328?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

19328 — Removing a breast implant that is still in good condition and hasn't ruptured or leaked.: Insurance Policy Changes

19328 Insurance Policy Changes

CPT 19328, in plain terms, covers Removing a breast implant that is still in good condition and hasn't ruptured or leaked. CPT 19328 is referenced in 8 tracked payer policy changes from Arkansas Blue Cross Blue Shield, Capital Blue Cross, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 19328 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

AB2026-02-003 Medical policies

Capital Blue Cross·Effective Mar 1, 2026

Capital Blue Cross has updated multiple medical policies effective March 1, 2026 and April 1, 2026, including new prior authorization requirements for medical specialty injectables (delegated to Prime MPS), new PA requirement for Blenrep drug (J9999 code), and revised criteria for numerous injectable medications, medical devices, and diagnostic procedures. Medical specialty injectable PA requests must now be submitted through Prime MPS GatewayPA Portal instead of Capital Blue Cross directly.

19328 Insurance Policy Changes

Payment Policy Material Amendment

AB2026-02-003 Medical policies

Breast Procedures - MEDICAID - KENTUCKY (Revised)

Breast Procedures - MEDICAID - OKLAHOMA (Revised)

Breast Procedures - MEDICAID - FLORIDA (Revised)

Breast Procedures - MEDICAID - VIRGINIA (Revised)

Breast Procedures - MEDICAID - SOUTH CAROLINA (Revised)

Breast Reconstruction Following Mastectomy