Question 1

What insurance policy changes affect CPT 27130?

Accepted Answer

There are 7 tracked policy changes affecting CPT 27130, including updates from Humana, Excellus BlueCross BlueShield, Blue Cross Blue Shield of Wyoming. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 27130?

Accepted Answer

Payers that have issued tracked updates for CPT 27130 include: Humana, Excellus BlueCross BlueShield, Blue Cross Blue Shield of Wyoming, BCBS Michigan, UnitedHealthcare, Blue Cross & Blue Shield of Mississippi.

Question 3

How do I get notified when CPT 27130 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 27130. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 27130?

Accepted Answer

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.

27130 Insurance Policy Changes

Hip Arthroplasty - Medicare Advantage (Revised)

Hip Arthroplasty 7.01.96

Enhancing Provider Support During Open Enrollment

Select musculoskeletal procedure codes continue to require prior authorization through e-referral for FEP members, won’t move to TurningPoint

Medicaid: Required documentation changes for hip and knee total joint replacements

Total Hip Arthroplasty (THA) - West Central and North East Region

Total Hip Arthroplasty (THA)