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PAYER POLICY CHANGES

64580 Insurance Policy Changes

CPT 64580, in plain terms, covers A surgeon makes an incision to place a stimulating device near nerves to help restore muscle function or reduce nerve pain. CPT 64580 is referenced in 4 tracked payer policy changes from Aetna 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 64580 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 64580 on AAPC

Watch 64580

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REFERENCE DATA

Payers with rules7
Payers requiring prior auth7
  • Aetna · Effective November 1, 2026

    Prior authorization required

    Participating provider precertification list for Aetna

  • Fidelis Care · Effective November 1, 2026

    Prior authorization required in some cases

    Fidelis Care Metal-Level Products authorization grid

  • BCBS Arizona · Effective October 1, 2026

    Prior authorization required

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

FREQUENTLY ASKED QUESTIONS

Does Aetna require prior authorization for 64580?

Aetna lists 64580 on Participating provider precertification list for Aetna for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does AmeriHealth Caritas require prior authorization for 64580?

AmeriHealth Caritas lists 64580 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does BCBS Arizona require prior authorization for 64580?

BCBS Arizona lists 64580 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.

Does BCBS Illinois require prior authorization for 64580?

BCBS Illinois lists 64580 on 2026 Commercial Outpatient Medical Surgical Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS Montana require prior authorization for 64580?

BCBS Montana lists 64580 on 2026 Commercial Medical Surgical Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 64580?

There are 4 tracked policy changes affecting CPT 64580, including updates from Aetna, 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 64580?

Payers that have issued tracked updates for CPT 64580 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 64580 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 64580. 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 64580?

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 64580

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 64580 in one place.

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