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PAYER POLICY CHANGES

21087 Insurance Policy Changes

CPT 21087, in plain terms, covers Making and fitting a custom artificial nose to replace a missing or damaged one. CPT 21087 is referenced in 5 tracked payer policy changes from Aetna and Independence Blue Cross. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 21087 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 21087 on AAPC

Watch 21087

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REFERENCE DATA

Payers with rules7
Payers requiring prior auth7
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • Blue Shield of California · Effective November 1, 2026

    Prior authorization required

    Prior Authorization List for Blue Shield Medicare

  • Colorado Medicaid · Effective July 1, 2026

    Prior authorization required

    Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column)

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for 21087?

Anthem BCBS lists 21087 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does BCBS Illinois require prior authorization for 21087?

BCBS Illinois lists 21087 on Blue Cross Community Health Plans (Illinois Medicaid) Prior Authorization Code List for medicaid managed plans, with conditions (list dated October 1, 2026). Verify with the payer before scheduling.

Does Blue Shield of California require prior authorization for 21087?

Blue Shield of California lists 21087 on Prior Authorization List for Blue Shield of California for commercial plans (list dated October 1, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 21087?

CalViva Health lists 21087 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 Colorado Medicaid require prior authorization for 21087?

Colorado Medicaid lists 21087 on Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column) for medicaid ffs plans (list dated July 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 21087?

There are 5 tracked policy changes affecting CPT 21087, including updates from Aetna, Independence Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 21087?

Payers that have issued tracked updates for CPT 21087 include: Aetna, Independence Blue Cross.

How do I get notified when CPT 21087 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 21087. 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 21087?

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 21087

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 21087 in one place.

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