Question 1

What insurance policy changes affect CPT 43243?

Accepted Answer

There are 4 tracked policy changes affecting CPT 43243, including updates from Anthem BCBS, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 43243?

Accepted Answer

Payers that have issued tracked updates for CPT 43243 include: Anthem BCBS, Aetna.

Question 3

How do I get notified when CPT 43243 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 43243. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 43243?

Accepted Answer

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.

43243 Insurance Policy Changes

[New York] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[Ohio] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

[Georgia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

Prolotherapy and Sclerotherapy (CPB 0207, reviewed 2026-03-27)