What insurance policy changes affect CPT 37242?

There are 10 tracked policy changes affecting CPT 37242, including updates from UnitedHealthcare, Blue Cross Blue Shield of Rhode Island, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 37242?

Payers that have issued tracked updates for CPT 37242 include: UnitedHealthcare, Blue Cross Blue Shield of Rhode Island, Aetna, Blue Cross Blue Shield of North Dakota, Humana.

How do I get notified when CPT 37242 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 37242. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 37242?

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.

37242 — A doctor uses special materials to block or close off a blood vessel to stop bleeding or treat an abnormal blood vessel.: Insurance Policy Changes

37242 Insurance Policy Changes

CPT 37242, in plain terms, covers A doctor uses special materials to block or close off a blood vessel to stop bleeding or treat an abnormal blood vessel. CPT 37242 is referenced in 10 tracked payer policy changes from UnitedHealthcare, Blue Cross Blue Shield of Rhode Island, and 3 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 37242 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

Ablation of Hepatic Lesions (CPB 0274, reviewed 2026-06-08)

Aetna·Effective Jun 8, 2026

Aetna updated its Clinical Policy Bulletin 0274 on hepatic lesion ablation (effective 2026-06-08), clarifying coverage criteria for cryosurgery, microwave, and radiofrequency ablation procedures. The policy specifies strict medical necessity requirements including isolated liver disease, tumor size ≤4 cm, liver involvement <50%, and patient unsuitability for open surgical resection. Multiple ablation techniques and indications remain classified as experimental/investigational, requiring billing teams to verify eligibility before claim submission.

37242 Insurance Policy Changes

New policy and prior auth requirement for select embolization procedures

Medical policy updates

Liver and Other Neoplasms - Treatment Approaches (CPB 0268, reviewed 2026-04-16)

Benign Prostatic Hyperplasia (CPB 0079, reviewed 2026-04-15)

Medical Policy Updates

Embolization: Selected Procedures (CPB 0856, reviewed 2026-01-12)

Prostate Artery Embolization - MEDICAID - MICHIGAN (New)

Prostate Artery Embolization - MEDICAID - INDIANA (New)

Prostate Artery Embolization - MEDICAID - ILLINOIS (New)

Ablation of Hepatic Lesions (CPB 0274, reviewed 2026-06-08)