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PAYER POLICY CHANGES

40520 Insurance Policy Changes

CPT 40520, in plain terms, covers Surgeon removes a V-shaped full-thickness section of the lip and closes it directly in a straight line. No tracked policy changes reference CPT 40520 yet. New payer updates are added daily, so check back soon or create a free alert to be notified the moment a change affects this code.

Official descriptor: CPT 40520 on AAPC

No policies yet

No tracked policy changes match this filter yet. New policies are added daily.

Watch 40520

Get one email when a payer policy names 40520, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

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REFERENCE DATA

Payers with rules4
Payers requiring prior auth4
  • Anthem BCBS · Effective October 19, 2026

    Prior authorization required

    Anthem local precertification/prior authorization list (Colorado | Anthem Blue Cross and Blue Shield | Commercial)

  • 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

FREQUENTLY ASKED QUESTIONS

Does AmeriHealth Caritas require prior authorization for 40520?

AmeriHealth Caritas lists 40520 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for 40520?

Anthem BCBS lists 40520 on Anthem local precertification/prior authorization list (Colorado | Anthem Blue Cross and Blue Shield | Commercial) for commercial plans (list dated October 19, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 40520?

CalViva Health lists 40520 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 40520?

Community Health Plan of Imperial Valley lists 40520 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.

What insurance policy changes affect CPT 40520?

No policy changes affecting CPT 40520 have been tracked yet. Check back as coverage expands.

Which payers have updated policy for CPT 40520?

No payer-specific updates have been tracked for CPT 40520 yet.

How do I get notified when CPT 40520 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 40520. 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 40520?

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 40520

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 40520 in one place.

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RELATED

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