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PAYER POLICY CHANGES

27870 Insurance Policy Changes

CPT 27870, in plain terms, covers A surgeon permanently joins the ankle bones together by making an incision to stabilize the joint. CPT 27870 is referenced in 4 tracked payer policy changes from Blue Cross and Blue Shield of Minnesota, Providence Health Plan, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 27870 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 27870 on AAPC

Watch 27870

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REFERENCE DATA

Payers with rules7
Payers requiring prior auth7
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • 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

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for 27870?

Ambetter lists 27870 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 Anthem BCBS require prior authorization for 27870?

Anthem BCBS lists 27870 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for 27870?

Arizona Complete Health lists 27870 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 27870?

BCBS Michigan lists 27870 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 27870?

CalViva Health lists 27870 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 27870?

There are 4 tracked policy changes affecting CPT 27870, including updates from Blue Cross and Blue Shield of Minnesota, Providence Health Plan, Capital Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 27870?

Payers that have issued tracked updates for CPT 27870 include: Blue Cross and Blue Shield of Minnesota, Providence Health Plan, Capital Blue Cross.

How do I get notified when CPT 27870 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 27870. 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 27870?

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 27870

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 27870 in one place.

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