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PAYER POLICY CHANGES

59100 Insurance Policy Changes

CPT 59100, in plain terms, covers Abdominal hysterotomy, opening the uterus through the abdomen, such as to remove a hydatidiform mole or end a pregnancy. CPT 59100 is referenced in 1 tracked payer policy change from Colorado Medicaid. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 59100 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 59100 on AAPC

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REFERENCE DATA

Payers with rules2
Payers requiring prior auth2
  • BCBS Michigan · Effective October 13, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

FREQUENTLY ASKED QUESTIONS

Does AmeriHealth Caritas require prior authorization for 59100?

AmeriHealth Caritas lists 59100 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 59100?

BCBS Michigan lists 59100 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans, with conditions (list dated October 13, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 59100?

There are 1 tracked policy change affecting CPT 59100, including updates from Colorado Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 59100?

Payers that have issued tracked updates for CPT 59100 include: Colorado Medicaid.

How do I get notified when CPT 59100 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 59100. 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 59100?

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 59100

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 59100 in one place.

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