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PAYER POLICY CHANGES

64742 Insurance Policy Changes

CPT 64742, in plain terms, covers Surgeon divides the facial nerve, either selectively or completely, to interrupt its function. CPT 64742 is referenced in 1 tracked payer policy change from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 64742 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 64742 on AAPC

Watch 64742

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REFERENCE DATA

Payers with rules4
Payers requiring prior auth4
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • Elevance Health · Effective February 11, 2026

    Prior authorization required

    List of items and services that require prior authorization (Medicaid GA)

  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for 64742?

Anthem BCBS lists 64742 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 64742?

CalViva Health lists 64742 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 64742?

Community Health Plan of Imperial Valley lists 64742 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 Elevance Health require prior authorization for 64742?

Elevance Health lists 64742 on List of items and services that require prior authorization (Medicaid GA) for medicaid managed plans (list dated February 11, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 64742?

There are 1 tracked policy change affecting CPT 64742, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 64742?

Payers that have issued tracked updates for CPT 64742 include: Aetna.

How do I get notified when CPT 64742 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 64742. 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 64742?

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 64742

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 64742 in one place.

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