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PAYER POLICY CHANGES

29891 Insurance Policy Changes

CPT 29891, in plain terms, covers Through an ankle scope, the surgeon cuts out an osteochondral defect on the talus, the tibia, or both, and drilling the defect site is included in this code. CPT 29891 is referenced in 2 tracked payer policy changes from Sentara Health Plans and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 29891 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 29891 on AAPC

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REFERENCE DATA

Payers with rules3
Payers requiring prior auth3
  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

  • Community Health Plan of Imperial Valley · Effective December 31, 2025

    Prior authorization required

    Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements

  • Fidelis Care · Effective December 31, 2025

    Prior authorization required

    Fidelis Care CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does CalViva Health require prior authorization for 29891?

CalViva Health lists 29891 on CalViva Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for 29891?

Community Health Plan of Imperial Valley lists 29891 on Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Fidelis Care require prior authorization for 29891?

Fidelis Care lists 29891 on Fidelis Care 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 29891?

There are 2 tracked policy changes affecting CPT 29891, including updates from Sentara Health Plans, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 29891?

Payers that have issued tracked updates for CPT 29891 include: Sentara Health Plans, Aetna.

How do I get notified when CPT 29891 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 29891. 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 29891?

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 29891

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 29891 in one place.

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