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PAYER POLICY CHANGES

25391 Insurance Policy Changes

CPT 25391, in plain terms, covers Osteoplasty in which the surgeon lengthens either the radius or the ulna, using autograft bone harvested from the patient. CPT 25391 is referenced in 1 tracked payer policy change from Regence BlueShield. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 25391 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 25391 on AAPC

Watch 25391

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REFERENCE DATA

Payers with rules3
Payers requiring prior auth3
  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

  • Community Health Plan of Imperial Valley · Effective December 31, 2025

    Prior authorization required

    Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements

  • Fidelis Care · Effective December 31, 2025

    Prior authorization required

    Fidelis Care CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does CalViva Health require prior authorization for 25391?

CalViva Health lists 25391 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 25391?

Community Health Plan of Imperial Valley lists 25391 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 Fidelis Care require prior authorization for 25391?

Fidelis Care lists 25391 on Fidelis Care CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

What insurance policy changes affect CPT 25391?

There are 1 tracked policy change affecting CPT 25391, including updates from Regence BlueShield. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 25391?

Payers that have issued tracked updates for CPT 25391 include: Regence BlueShield.

How do I get notified when CPT 25391 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 25391. 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 25391?

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 25391

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 25391 in one place.

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