Does Ambetter require prior authorization for 44135?

Ambetter lists 44135 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does AmeriHealth Caritas require prior authorization for 44135?

AmeriHealth Caritas lists 44135 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 44135?

Anthem BCBS lists 44135 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for 44135?

Arizona Complete Health lists 44135 on Arizona Complete Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does BCBS Arizona require prior authorization for 44135?

BCBS Arizona lists 44135 on AZ Blue Standard Prior Authorization Requirements Code List (Updated 10/01/2026) for commercial plans (list dated October 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 44135?

There are 6 tracked policy changes affecting CPT 44135, including updates from Premera Blue Cross, Excellus BlueCross BlueShield, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 44135?

Payers that have issued tracked updates for CPT 44135 include: Premera Blue Cross, Excellus BlueCross BlueShield, Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 44135 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 44135. 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 44135?

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.

PAYER POLICY CHANGES

44135 Insurance Policy Changes

CPT 44135 is referenced in 6 tracked payer policy changes from Premera Blue Cross, Excellus BlueCross BlueShield, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 44135 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Premera Blue Cross · Identified Jun 16, 2026High impact
Medical Policy and Coding Updates - December 2025
With effective dates from December 1, 2025 through March 4, 2026. The update adds medical necessity and prior authorization review for electrophysiology studies, endovascular stent grafts for abdominal aortic aneurysms, shoulder arthrotomy, gastroesophageal reflux surgery, negative pressure wound therapy devices, and hip, knee and spine surgeries for Standard and Basic Federal Employee Program plans effective January 1, 2026. Several codes were made non-covered or investigational, including the services listed under policy 10.01.517 and transcatheter tricuspid valve procedures.
Excellus BlueCross BlueShield · Effective Mar 19, 2026Medium impact
Small Bowel and Multivisceral Transplants in Adults and Children 7.02.05
Excellus BlueCross BlueShield policy 07.02.05 covers small bowel (SB) transplant in pediatric and adult patients with short bowel syndrome for listed indications. These include impending or overt liver failure from TPN-induced liver injury, thrombosis of two or more central veins, two or more hospitalized episodes per year of line-related systemic sepsis, a single episode of line-related fungemia, septic shock or acute respiratory distress syndrome, and frequent episodes of severe dehydration despite IV fluids plus TPN. Multivisceral transplant is considered medically appropriate in pediatric and adult patients with intestinal failure and concurrent liver failure. SB transplant for patients with intestinal failure who can tolerate TPN, and SB transplant using live donor tissue, are considered investigational. Candidates must also meet listed criteria for cardiopulmonary status, absence of active infection, absence of malignancy, and documented compliance with medical management.
Aetna · Identified Oct 6, 2026Medium impact
Intestinal Transplantation (CPB 0605, reviewed 2026-09-03)
Aetna's Intestinal Transplantation policy (CPB 0605) treats intestinal transplant as medically necessary for persons with clinical indicators of failed total parenteral nutrition (TPN), such as frequent severe dehydration despite IV fluids, 2 or more hospitalized episodes of line-infection sepsis per year, impending or overt liver failure, or thrombosis or loss of central venous access, when the selection criteria are met. Combined intestinal and liver transplant is medically necessary for advanced liver disease that requires liver transplantation when the same criteria are met, except for the liver function requirement, and multi-visceral transplants from deceased donors are medically necessary for adults and children who meet the combined small bowel/liver criteria and need one or more additional abdominal organs. Fecal calprotectin testing for intestinal allograft rejection and intestinal transplant for recurrent non-resectable pseudomyxoma peritonei are listed as experimental, investigational or unproven, and the policy was last reviewed 09/03/2026.
Aetna · Identified Aug 19, 2026Medium impact
Intestinal Transplantation (CPB 0605, reviewed 2025-09-10)
Aetna considers intestinal transplantation medically necessary for persons with clinical indicators of failed total parenteral nutrition (TPN) who meet the selection criteria. The selection criteria include absence of acute or chronic active infections that are not effectively treated, an ejection fraction greater than or equal to 40%, a bilirubin of less than 2.5 mg/dL, a creatinine clearance greater than 50 mL/min/kg, and controlled HIV/AIDS. Intestinal transplant is considered not medically necessary for persons with contraindications such as refractory heart failure with an ejection fraction less than 40%, untreated malignancy, multi-organ failure, sepsis, or inability to adhere to the transplant regimen, including homelessness, active substance abuse, or unstable psychiatric disease.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Isolated Small Bowel Transplant
Cadaveric small bowel transplant may be considered medically necessary for adult and pediatric individuals with intestinal failure who have established long-term dependence on total parenteral nutrition and are developing or have developed severe TPN complications. Living donor small bowel transplant may be considered medically necessary only when a cadaveric intestine is not available for an individual who meets the cadaveric criteria, and a small bowel retransplant may be considered medically necessary after a failed primary small bowel transplant. Small bowel transplant is considered investigational for adult and pediatric individuals with intestinal failure who are able to tolerate TPN, and living donor small bowel transplant is considered investigational in all other situations.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Small Bowel/Liver and Multivisceral Transplant
Small bowel/liver or multivisceral transplant may be considered medically necessary for pediatric and adult individuals with intestinal failure who have been managed with long-term total parenteral nutrition and have developed evidence of impending end-stage liver failure. Retransplantation after a failed primary small bowel/liver or multivisceral transplant may be considered medically necessary. The transplant is considered investigational in individuals with known current malignancy including metastatic cancer, recent malignancy with a high risk of recurrence, untreated systemic infection making immunosuppression unsafe, or other irreversible end-stage disease not attributed to intestinal failure.

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Medical Policy and Coding Updates - December 2025

Small Bowel and Multivisceral Transplants in Adults and Children 7.02.05

Intestinal Transplantation (CPB 0605, reviewed 2026-09-03)

Intestinal Transplantation (CPB 0605, reviewed 2025-09-10)

Isolated Small Bowel Transplant

Small Bowel/Liver and Multivisceral Transplant

Prior authorization required