Question 1

What insurance policy changes affect CPT 27438?

Accepted Answer

There are 4 tracked policy changes affecting CPT 27438, including updates from Sentara Health Plans, Humana, 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 27438?

Accepted Answer

Payers that have issued tracked updates for CPT 27438 include: Sentara Health Plans, Humana, Blue Cross Blue Shield of Wyoming, BCBS Michigan.

Question 3

How do I get notified when CPT 27438 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 27438. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 27438?

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.

27438 Insurance Policy Changes

Medical and Clinical Policy Updates - Effective October 1, 2026

Knee Arthroplasty - Medicare Advantage (Revised)

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