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PAYER POLICY CHANGES

27424 Insurance Policy Changes

CPT 27424, in plain terms, covers Surgeon reconstructs a kneecap that keeps dislocating and includes removal of the patella. CPT 27424 is referenced in 9 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 27424 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 27424 on AAPC

Watch 27424

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REFERENCE DATA

Payers with rules12
Payers requiring prior auth12
  • 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)

  • BCBS Illinois · Effective October 1, 2026

    Prior authorization required in some cases

    Blue Cross Community Health Plans (Illinois Medicaid) Prior Authorization Code List

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for 27424?

Ambetter lists 27424 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 BCBS Arizona require prior authorization for 27424?

BCBS Arizona lists 27424 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 27424?

BCBS Illinois lists 27424 on Blue Cross Community Health Plans (Illinois Medicaid) Prior Authorization Code List for medicaid managed plans, with conditions (list dated October 1, 2026). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 27424?

BCBS Michigan lists 27424 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 27424?

CalViva Health lists 27424 on CalViva Health 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 27424?

There are 9 tracked policy changes affecting CPT 27424, 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 27424?

Payers that have issued tracked updates for CPT 27424 include: Excellus BlueCross BlueShield, Blue Cross Blue Shield of Nebraska, Premera Blue Cross, Regence BlueShield.

How do I get notified when CPT 27424 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 27424. 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 27424?

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 27424

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 27424 in one place.

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