CPT 28899 is referenced in 8 tracked payer policy changes from Nevada Medicaid, Blue Cross & Blue Shield of Mississippi, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 28899 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Nevada Medicaid has removed prior authorization requirements for 13 procedure codes effective December 1, 2025, when billed by specific provider types. This simplifies the billing process for procedures including cataract surgery, skin lesion destruction, facial bone procedures, and various unlisted procedures.
Radiofrequency coblation tenotomy is considered investigational as a treatment for musculoskeletal conditions, including plantar fasciitis, lateral epicondylitis, shoulder or rotator cuff tendinopathy, Achilles tendinopathy, patellar tendinopathy and wrist tendinopathy. Bipolar radiofrequency energy is directed into the tendon during tenotomy, and the policy states that investigational treatments are not considered medically necessary under its definition. The investigational codes listed in the policy are unlisted procedure codes for the shoulder, humerus or elbow, forearm or wrist, leg or ankle, and foot or toes.
Subtalar arthroereisis is considered investigational. The procedure places an implant in the sinus tarsi, which is a canal between the talus and the calcaneus, to correct excessive talar displacement and calcaneal eversion by reducing pronation across the subtalar joint. Investigative procedures are not considered medically necessary because they are not yet recognized as a generally accepted standard of good medical practice for the treated condition.
Synthetic cartilage implants are considered investigational for the treatment of articular cartilage damage. The Cartiva synthetic polyvinyl alcohol implant was FDA-approved in 2016 for painful degenerative or posttraumatic arthritis in the first metatarsophalangeal joint, and the policy states that the Federal Employee Program may dictate that FDA-approved devices are not considered investigational and may be assessed only on the basis of medical necessity. The 09/11/2025 review made no changes to the policy statement.
This is a reissue with no substantive changes to Independence Blue Cross Medicare Advantage policy MA07.047h. The policy was rereviewed on 11/26/2025 per annual review process and remains unchanged. Billing teams should confirm their current processes align with the existing coverage criteria for peripheral nerve injections (carpal tunnel, tarsal tunnel, and intermetatarsal neuromas), the three-injection limit per site in six months, and the two-site maximum per session rule.
This is a routine annual reissue of Independence Administrators' osteochondral allograft transplantation policy with no substantive changes to coverage criteria, billing codes, or medical necessity requirements. The policy continues to cover osteochondral allograft procedures for knee and talus lesions meeting specific size and clinical criteria, and applies only to Independence Administrators claims (not Commercial Independence members who use AIM guidelines).
Independence Blue Cross reissued Policy 07.03.27 on 11/26/2025 with no substantive changes to pain management peripheral nerve injection coverage. The policy maintains existing coverage criteria for carpal tunnel syndrome, tarsal tunnel syndrome, and intermetatarsal neuromas, with a 3-injection limit per anatomic site in 6 months and maximum of 2 anatomic sites per session.
This is a routine annual reissue of Independence Administrators' osteochondral allograft transplantation policy with no substantive changes to coverage criteria, billing codes, or medical necessity requirements. The policy continues to cover osteochondral allograft for knee and talus defects under specific clinical criteria and only applies to Independence Administrators members whose groups have not enrolled in the UM vendor program.
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