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PAYER POLICY CHANGES

23460 Insurance Policy Changes

CPT 23460, in plain terms, covers Surgeon repairs the anterior shoulder joint capsule for instability and performs a bone block procedure through an open approach. CPT 23460 is referenced in 11 tracked payer policy changes from Excellus BlueCross BlueShield, Blue Cross Blue Shield of Nebraska, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 23460 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 23460 on AAPC

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REFERENCE DATA

Payers with rules17
Payers requiring prior auth17
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

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

  • 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)

  • BCBS Arizona · Effective October 1, 2026

    Prior authorization required

    AZ Blue Medicare Advantage Prior Authorization Requirements Code List (Updated 10/01/2026)

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for 23460?

Ambetter lists 23460 on Ambetter Health of Delaware CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for 23460?

Anthem BCBS lists 23460 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 Arizona require prior authorization for 23460?

BCBS Arizona lists 23460 on AZ Blue Medicare Advantage Prior Authorization Requirements Code List (Updated 10/01/2026) for medicare advantage plans (list dated October 1, 2026). Verify with the payer before scheduling.

Does BCBS Illinois require prior authorization for 23460?

BCBS Illinois lists 23460 on 2026 Commercial Outpatient Medical Surgical Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 23460?

BCBS Michigan lists 23460 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.

What insurance policy changes affect CPT 23460?

There are 11 tracked policy changes affecting CPT 23460, including updates from Excellus BlueCross BlueShield, Blue Cross Blue Shield of Nebraska, Premera Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 23460?

Payers that have issued tracked updates for CPT 23460 include: Excellus BlueCross BlueShield, Blue Cross Blue Shield of Nebraska, Premera Blue Cross, Regence BlueShield.

How do I get notified when CPT 23460 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 23460. 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 23460?

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 23460

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 23460 in one place.

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