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PAYER POLICY CHANGES

50080 Insurance Policy Changes

CPT 50080, in plain terms, covers Percutaneous nephrolithotomy or pyelolithotomy to break up or remove simple kidney stones up to 2 cm. CPT 50080 is referenced in 2 tracked payer policy changes from BCBS Arizona and Colorado Medicaid. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 50080 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 50080 on AAPC

Watch 50080

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REFERENCE DATA

Payers with rules4
Payers requiring prior auth4
  • BCBS Arizona · Effective October 1, 2026

    Prior authorization required in some cases

    AZ Blue Standard Prior Authorization Requirements Code List (Updated 10/01/2026)

  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

  • Community Health Plan of Imperial Valley · Effective December 31, 2025

    Prior authorization required

    Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does BCBS Arizona require prior authorization for 50080?

BCBS Arizona lists 50080 on AZ Blue Standard Prior Authorization Requirements Code List (Updated 10/01/2026) for commercial plans, with conditions (list dated October 1, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 50080?

CalViva Health lists 50080 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 Community Health Plan of Imperial Valley require prior authorization for 50080?

Community Health Plan of Imperial Valley lists 50080 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.

Does Fidelis Care require prior authorization for 50080?

Fidelis Care lists 50080 on Fidelis Care 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 50080?

There are 2 tracked policy changes affecting CPT 50080, including updates from BCBS Arizona, Colorado Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 50080?

Payers that have issued tracked updates for CPT 50080 include: BCBS Arizona, Colorado Medicaid.

How do I get notified when CPT 50080 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 50080. 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 50080?

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 50080

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 50080 in one place.

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