Start free
PAYER POLICY CHANGES

25442 Insurance Policy Changes

CPT 25442, in plain terms, covers Open arthroplasty replacing the end of the ulna bone at the wrist with a prosthetic implant. CPT 25442 is referenced in 1 tracked payer policy change from Capital Blue Cross. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 25442 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 25442 on AAPC

Watch 25442

Get one email when a payer policy names 25442, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

No account needed. We send a confirmation link first, and every email has a one-click stop link.

REFERENCE DATA

Payers with rules10
Payers requiring prior auth10
  • 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)

  • Ambetter · Effective December 31, 2025

    Prior authorization required

    Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements

  • Arizona Complete Health · Effective December 31, 2025

    Prior authorization required

    Arizona Complete Health CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for 25442?

Ambetter lists 25442 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for 25442?

Arizona Complete Health lists 25442 on Arizona Complete Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 25442?

BCBS Michigan lists 25442 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.

Does CalViva Health require prior authorization for 25442?

CalViva Health lists 25442 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 Capital Blue Cross require prior authorization for 25442?

Capital Blue Cross lists 25442 on Capital Blue Cross single source preauthorization code list for commercial plans, with conditions. Verify with the payer before scheduling.

What insurance policy changes affect CPT 25442?

There are 1 tracked policy change affecting CPT 25442, including updates from Capital Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 25442?

Payers that have issued tracked updates for CPT 25442 include: Capital Blue Cross.

How do I get notified when CPT 25442 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 25442. 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 25442?

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 25442

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 25442 in one place.

See every payer rule

RELATED

All billing codesJ3590C9399J3490992159921399202

Get alerts for changes like this

Save a search and get email alerts when a new policy change matches your filters: daily or weekly, your choice, on every plan.

Create a free alertHow Policy Monitoring works