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PAYER POLICY CHANGES

21070 Insurance Policy Changes

CPT 21070, in plain terms, covers Coronoidectomy, surgical removal of the coronoid process, the bony projection on the lower jaw. Bill it only when this is the sole jaw work done at that session. CPT 21070 is referenced in 6 tracked payer policy changes from Excellus BlueCross BlueShield and Humana. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 21070 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 21070 on AAPC

Watch 21070

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REFERENCE DATA

Payers with rules6
Payers requiring prior auth6
  • Aetna · Effective November 1, 2026

    Prior authorization required

    Participating provider precertification list for Aetna

  • BCBS Michigan · Effective October 13, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

  • CountyCare Health Plan · Effective April 23, 2026

    Prior authorization required

    CountyCare Prior Authorization Look-Up Tool (All Codes)

FREQUENTLY ASKED QUESTIONS

Does Aetna require prior authorization for 21070?

Aetna lists 21070 on Participating provider precertification list for Aetna for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 21070?

BCBS Michigan lists 21070 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans, with conditions (list dated October 13, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 21070?

CalViva Health lists 21070 on CalViva Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for 21070?

Community Health Plan of Imperial Valley lists 21070 on Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does CountyCare Health Plan require prior authorization for 21070?

CountyCare Health Plan lists 21070 on CountyCare Prior Authorization Look-Up Tool (All Codes) for medicaid managed plans (list dated April 23, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 21070?

There are 6 tracked policy changes affecting CPT 21070, including updates from Excellus BlueCross BlueShield, Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 21070?

Payers that have issued tracked updates for CPT 21070 include: Excellus BlueCross BlueShield, Humana.

How do I get notified when CPT 21070 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 21070. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 21070?

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.

See every payer rule for 21070

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 21070 in one place.

See every payer rule

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