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PAYER POLICY CHANGES

42699 Insurance Policy Changes

CPT 42699 is referenced in 1 tracked payer policy change from Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 42699 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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REFERENCE DATA

Payers with rules7
Payers requiring prior auth7
  • BCBS Michigan · Effective October 13, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

  • CountyCare Health Plan · Effective April 23, 2026

    Prior authorization required

    CountyCare Prior Authorization Look-Up Tool (All Codes)

  • Cigna · Effective March 7, 2026

    Prior authorization required

    Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs (EviCore)

FREQUENTLY ASKED QUESTIONS

Does AmeriHealth Caritas require prior authorization for 42699?

AmeriHealth Caritas lists 42699 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 42699?

BCBS Michigan lists 42699 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans, with conditions (list dated October 13, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 42699?

CalViva Health lists 42699 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 Cigna require prior authorization for 42699?

Cigna lists 42699 on Cigna Master Precertification List for commercial plans (list dated October 1, 2026). Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for 42699?

Community Health Plan of Imperial Valley lists 42699 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 42699?

There are 1 tracked policy change affecting CPT 42699, including updates from Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 42699?

Payers that have issued tracked updates for CPT 42699 include: Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 42699 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 42699. 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 42699?

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 42699

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 42699 in one place.

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