What insurance policy changes affect CPT 21143?

There are 8 tracked policy changes affecting CPT 21143, including updates from Blue Cross Blue Shield of Rhode Island, Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 21143?

Payers that have issued tracked updates for CPT 21143 include: Blue Cross Blue Shield of Rhode Island, Humana.

How do I get notified when CPT 21143 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 21143. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 21143?

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.

21143 — Reconstructing the upper jaw bone that's been severely fractured, requiring multiple surgical pieces to realign.: Insurance Policy Changes

21143 Insurance Policy Changes

CPT 21143, in plain terms, covers Reconstructing the upper jaw bone that's been severely fractured, requiring multiple surgical pieces to realign. CPT 21143 is referenced in 8 tracked payer policy changes from Blue Cross Blue Shield of Rhode Island and Humana. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 21143 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

Medical policy updates

Blue Cross Blue Shield of Rhode Island·Effective Jul 1, 2026

Effective July 1, 2026, multiple policy changes include removing prior authorization for chronic liver disease testing (CPT 0344U), adding prior authorization requirements for tibial nerve stimulation, changing orthognathic surgery codes to use general prior authorization criteria instead of specialty-specific criteria, and updating various other testing and procedure requirements across Medicare Advantage and commercial plans.

21143 Insurance Policy Changes

Medical policy updates

Orthognathic Surgery - MEDICAID - VIRGINIA (New)

Orthognathic Surgery - MEDICAID - OKLAHOMA (Revised)

Orthognathic Surgery - MEDICAID - FLORIDA (New)

Orthognathic Surgery - MEDICAID - SOUTH CAROLINA (New)

Orthognathic Surgery - MEDICAID - MICHIGAN (New)

Orthognathic Surgery - MEDICAID - OKLAHOMA (New)

Orthognathic Surgery - Medicare Advantage (Revised)