55842 Insurance Policy Changes

CPT 55842, in plain terms, covers Surgery involving removal of a large portion of the prostate gland and surrounding tissue to treat cancer or other serious conditions. CPT 55842 is referenced in 1 tracked payer policy change from Humana. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 55842 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 55842 on AAPC

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