What insurance policy changes affect CPT 42140?

There are 7 tracked policy changes affecting CPT 42140, including updates from Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 42140?

Payers that have issued tracked updates for CPT 42140 include: Humana.

How do I get notified when CPT 42140 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 42140. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 42140?

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.

42140 — Surgical removal of the small tissue flap hanging down in the back of your throat.: Insurance Policy Changes

42140 Insurance Policy Changes

CPT 42140, in plain terms, covers Surgical removal of the small tissue flap hanging down in the back of your throat. CPT 42140 is referenced in 7 tracked payer policy changes from Humana. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 42140 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments - Medicare Advantage (Revised)

Humana·Effective Jun 1, 2026

Humana Medicare Advantage updated coverage criteria for obstructive sleep apnea surgical treatments, establishing specific medical necessity requirements for procedures like uvulopalatopharyngoplasty and genioglossal advancement, while excluding coverage for certain procedures like tongue-based suspension surgery and uvulectomy as standalone OSA treatment.

42140 Insurance Policy Changes

Obstructive Sleep Apnea Interventional Therapy - MEDICAID - FLORIDA (New)

Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments - Medicare Advantage (Revised)

Obstructive Sleep Apnea Interventional Therapy - MEDICAID - VIRGINIA (New)

Obstructive Sleep Apnea Interventional Therapy - MEDICAID - SOUTH CAROLINA (New)

Obstructive Sleep Apnea Interventional Therapy - MEDICAID - MICHIGAN (New)

Obstructive Sleep Apnea Interventional Therapy - MEDICAID - ILLINOIS (New)

Obstructive Sleep Apnea Interventional Therapy - MEDICAID - INDIANA (New)