CPT 23700, in plain terms, covers Manipulating the shoulder joint while the patient is under anesthesia, including applying a cast or fixation device, typically to free a stiff joint. CPT 23700 is referenced in 14 tracked payer policy changes from UnitedHealthcare, Excellus BlueCross BlueShield, and 5 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 23700 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Official descriptor: CPT 23700 on AAPC
UnitedHealthcare is removing a long list of CPT codes from the applicable-code list of its Outpatient Surgical Procedures site-of-service policy for Exchange plans, and it is also removing the link to the Manipulation Under Anesthesia policy. The change takes effect December 1, 2026. The source does not state a new billing requirement for the removed codes.
Effective December 1, 2026, UMR removes more than 500 CPT codes from its Outpatient Surgical Procedures - Site of Service medical policy for commercial plans, and it drops a reference link to the Manipulation Under Anesthesia policy. For those codes, UMR's site-of-service policy no longer applies, so the practice should update its internal UMR site-of-service and prior authorization lists before that date.
Effective December 1, 2026, UnitedHealthcare removes more than 500 CPT codes from its Outpatient Surgical Procedures - Site of Service medical policy for commercial plans, and it drops a reference link to the Manipulation Under Anesthesia policy. For those codes, the site-of-service policy no longer applies under this UnitedHealthcare commercial policy, so the practice should update its internal site-of-service and prior authorization lists before that date.
Excellus BlueCross BlueShield medical policy 7.01.125 sets the medical necessity criteria for shoulder joint procedures for Managed Medicaid, Health and Recovery Plan, Child Health Plus and Essential Plan members, with a current effective date of January 1, 2027. It covers total and reverse shoulder arthroplasty, hemiarthroplasty, revision arthroplasty, shoulder arthroscopy and related procedures, and states the criteria for each, including imaging, conservative management, nicotine or tobacco use within 6 weeks of surgery, and HbA1c limits for members with diabetes. The policy history also lists an off-cycle update dated 10/22/26 that removed site of service criteria.
Excellus BlueCross BlueShield policy 7.01.125 sets medical necessity criteria for shoulder joint procedures for Managed Medicaid, Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) members, with a current effective date of January 1, 2027. The criteria cover total and reverse total shoulder arthroplasty, hemiarthroplasty, revision of shoulder arthroplasty, shoulder arthroscopy, rotator cuff repair, labral repair, capsulorrhaphy, synovectomy, biceps tenotomy or tenodesis, subacromial decompression and other shoulder procedures. A new policy was issued 09/17/26, and an off-cycle update on 10/22/26 removed site of service criteria.
Blue Cross and Blue Shield of Nebraska's updates effective 11/01/2026, which have already taken effect, add a new Evolent preauthorization requirement for listed hip, knee and shoulder surgery codes, a preauthorization requirement for psychological and neuropsychological testing after the fifth hour of testing, and new codes 15271 through 15278 under its amniotic membrane and bioengineered skin substitute policies. All of these require preauthorization according to the notice.
Blue Cross and Blue Shield of Nebraska's MPC November 2026 update lists two policies effective 11/01/2026. New policy III.277 Evolent Joint Surgery (Hip, Knee, Shoulder Surgeries) applies to all employer groups and requires preauthorization, which Evolent performs. Revised policy I.200 Amniotic Membrane and Amniotic Fluid and I.202 Bioengineered Skin and Soft Tissue Substitutes adds codes 15271 through 15278 and also requires preauthorization.
Effective March 1, 2026, a number of codes newly require preauthorization for Commercial and Medicare Advantage members, including 20985, 22100 and 27860, and HCPCS code H0032 will be denied because the service is not provided directly to members. Codes C1605, C1721 and others no longer require preauthorization effective February 1, 2026, Evolent updated its CT, MRI, PET and cardiac imaging policies effective March 1, 2026, and TurningPoint accepts listed substitute codes for a limited group of musculoskeletal surgical procedures effective February 1, 2026. Effective for claims processed on or after March 1, 2026, facility claims with modifiers 59, XE, XP, XS and XU that do not meet the CMS criteria to bypass an NCCI procedure-to-procedure edit will be rejected, and physical medicine code 97140 is not separately reimbursed when billed with chiropractic manipulative treatment in the same anatomical region.
Sentara Health Plans' authorization updates effective June 1, 2025 updated criteria for benign prostatic hypertrophy treatments, cosmetic and reconstructive surgery, augmentative communication devices, hospital beds and keratoconus lenses for Commercial and Medicaid plans, and archived the photodynamic therapy, early inpatient admission and transplant rejection testing policies on June 1, 2025. The notice combined the intestinal, heart-lung and pancreas and islet cell transplant policies into a new Solid Organ Transplantation policy (Surgical 236). Separate updates removed prior authorization for 56 Medicare procedure codes, 49 Medicaid procedure codes and 48 Commercial procedure codes effective April 1, 2025.
Aetna considers manipulation under anesthesia (MUA) medically necessary for arthrofibrosis of the knee following total knee arthroplasty, knee surgery, or fracture, for chronic refractory frozen shoulder (adhesive capsulitis), and for temporomandibular joint disorders. Spinal manipulation under general MUA is considered experimental, investigational, or unproven, and CPT 22505 is not covered for the indications listed in the policy. The policy does not apply to examinations under anesthesia, or to setting fractures or complete joint dislocations under anesthesia.
This is a reissue with no substantive changes to MA11.091b, Independence Blue Cross's Medicare Advantage policy on Manipulation Under Anesthesia. The policy maintains existing coverage criteria for four medically necessary MUA procedures (shoulder adhesive capsulitis, knee arthrofibrosis, acute/traumatic dislocations, and fracture reductions) while continuing to classify spinal MUA, MUA for non-shoulder adhesive capsulitis, non-knee arthrofibrosis, TMJ disorders, and other joint pain as experimental/investigational and not covered.
This is a reissue with no substantive changes to Independence Blue Cross Medicare Advantage policy MA11.091b on Manipulation Under Anesthesia. The policy maintains coverage for MUA on shoulder adhesive capsulitis, knee arthrofibrosis, and acute fracture/dislocation reductions, while continuing to classify spinal MUA, MUA for non-shoulder adhesive capsulitis, non-knee arthrofibrosis, TMJ disorders, and other joint pain as experimental/investigational (not covered). No billing codes, coverage criteria, or medical necessity guidelines have been altered.
Independence Blue Cross reissued Medical Policy Bulletin 11.14.24b on 03/04/2026 with no substantive changes to Manipulation Under Anesthesia coverage criteria. The policy maintains the same medically necessary indications (frozen shoulder, knee arthrofibrosis, closed reductions) and experimental/investigational exclusions (spinal MUA, non-shoulder adhesive capsulitis, TMJ disorders, serial treatments). This is a routine annual review reissuance with no new billing codes, coverage changes, or operational impacts for the billing team.
Independence Blue Cross has reissued Policy 11.14.24b on Manipulation Under Anesthesia with no substantive changes to coverage criteria. The policy continues to cover MUA for frozen shoulder, knee arthrofibrosis, and traumatic dislocations/fractures, while excluding spinal MUA, MUA for other joints, and serial treatment sessions as experimental/investigational. This is a routine annual reissue with no impact to current billing practices.
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