CPT 65865, in plain terms, covers Surgeon cuts goniosynechiae, adhesions in the anterior chamber drainage angle, using an incisional technique, possibly injecting air or liquid. CPT 65865 is referenced in 4 tracked payer policy changes from UnitedHealthcare and Sentara Health Plans. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 65865 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Official descriptor: CPT 65865 on AAPC
UnitedHealthcare is removing a long list of CPT codes from the applicable-code list of its Outpatient Surgical Procedures site-of-service policy for Exchange plans, and it is also removing the link to the Manipulation Under Anesthesia policy. The change takes effect December 1, 2026. The source does not state a new billing requirement for the removed codes.
Effective December 1, 2026, UMR removes more than 500 CPT codes from its Outpatient Surgical Procedures - Site of Service medical policy for commercial plans, and it drops a reference link to the Manipulation Under Anesthesia policy. For those codes, UMR's site-of-service policy no longer applies, so the practice should update its internal UMR site-of-service and prior authorization lists before that date.
Effective December 1, 2026, UnitedHealthcare removes more than 500 CPT codes from its Outpatient Surgical Procedures - Site of Service medical policy for commercial plans, and it drops a reference link to the Manipulation Under Anesthesia policy. For those codes, the site-of-service policy no longer applies under this UnitedHealthcare commercial policy, so the practice should update its internal site-of-service and prior authorization lists before that date.
Sentara Health Plans' authorization updates effective June 1, 2025 updated criteria for benign prostatic hypertrophy treatments, cosmetic and reconstructive surgery, augmentative communication devices, hospital beds and keratoconus lenses for Commercial and Medicaid plans, and archived the photodynamic therapy, early inpatient admission and transplant rejection testing policies on June 1, 2025. The notice combined the intestinal, heart-lung and pancreas and islet cell transplant policies into a new Solid Organ Transplantation policy (Surgical 236). Separate updates removed prior authorization for 56 Medicare procedure codes, 49 Medicaid procedure codes and 48 Commercial procedure codes effective April 1, 2025.
Watch 65865
Get one email when a payer policy names 65865, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.
See every payer rule for 65865
Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 65865 in one place.
Get alerts for changes like this
Save a search and get email alerts when a new policy change matches your filters: daily or weekly, your choice, on every plan.