What insurance policy changes affect CPT 43889?

There are 17 tracked policy changes affecting CPT 43889, including updates from CareSource, Anthem BCBS, Medical Mutual of Ohio. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 43889?

Payers that have issued tracked updates for CPT 43889 include: CareSource, Anthem BCBS, Medical Mutual of Ohio, SelectHealth, Blue Cross NC, Harvard Pilgrim Health Care.

How do I get notified when CPT 43889 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 43889. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 43889?

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.

43889 — A surgeon creates a new passageway to bypass a blocked esophagus using a minimally invasive approach through the mouth.: Insurance Policy Changes

43889 Insurance Policy Changes

CPT 43889, in plain terms, covers A surgeon creates a new passageway to bypass a blocked esophagus using a minimally invasive approach through the mouth. CPT 43889 is referenced in 17 tracked payer policy changes from CareSource, Anthem BCBS, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 43889 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

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

Anthem BCBS·Effective Nov 1, 2026

Effective November 1, 2026, Anthem Blue Cross Blue Shield in Georgia is adding four specific surgical and device codes to Carelon Medical Benefits Management's prior authorization requirements. Providers must obtain precertification before performing these procedures: two neurostimulation procedures for bladder dysfunction (CPT 0988T, 0989T), endoscopic sleeve gastroplasty (CPT 43889), and an integrated neurostimulator device (HCPCS C1607). Claims submitted without prior authorization will be denied.

43889 Insurance Policy Changes

[Georgia] Prior Authorization Requirement Update

[Ohio] Precertification/prior authorization requirement changes

[California] Precertification/prior authorization requirement changes

[Virginia] Prior authorization requirement changes

[Virginia] Precertification/prior authorization requirement changes

[California] Prior authorization requirement changes

[New York] Precertification/prior authorization requirement changes

[Ohio] Precertification/prior authorization requirement changes

[Georgia] Precertification/prior authorization requirement changes

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

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

[Virginia] Precertification/prior authorization requirements — Carelon Medical Benefits Management

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

Mutual News April 2026 Newsletter

January 2026

Medical Policy Update December 31, 2025

Point32Health Medical Necessity Guideline updates