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PAYER POLICY CHANGES

62368 Insurance Policy Changes

CPT 62368, in plain terms, covers Electronic analysis of an implanted spinal infusion pump with reprogramming of its settings and no refill. CPT 62368 is referenced in 2 tracked payer policy changes from Capital Blue Cross and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 62368 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 62368 on AAPC

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REFERENCE DATA

Payers with rules5
Payers requiring prior auth5
  • Excellus BlueCross BlueShield · Effective October 1, 2026

    Prior authorization required in some cases

    Excellus BCBS utilization management standard clinical review preauthorization list

  • Arizona Complete Health · Effective December 31, 2025

    Prior authorization required

    Arizona Complete Health CMS-0057-F prior authorization requirements

  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Arizona Complete Health require prior authorization for 62368?

Arizona Complete Health lists 62368 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 CalViva Health require prior authorization for 62368?

CalViva Health lists 62368 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 Capital Blue Cross require prior authorization for 62368?

Capital Blue Cross lists 62368 on Capital Blue Cross single source preauthorization code list for commercial plans. Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for 62368?

Community Health Plan of Imperial Valley lists 62368 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 Excellus BlueCross BlueShield require prior authorization for 62368?

Excellus BlueCross BlueShield lists 62368 on Excellus BCBS utilization management standard clinical review preauthorization list for commercial plans, with conditions (list dated October 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 62368?

There are 2 tracked policy changes affecting CPT 62368, including updates from Capital Blue Cross, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 62368?

Payers that have issued tracked updates for CPT 62368 include: Capital Blue Cross, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 62368 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 62368. 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 62368?

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 62368

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 62368 in one place.

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