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PAYER POLICY CHANGES

67808 Insurance Policy Changes

CPT 67808, in plain terms, covers Surgeon removes one or more chalazia from the eyelid when the case needs general anesthesia or a hospital setting. CPT 67808 is referenced in 3 tracked payer policy changes from UnitedHealthcare. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 67808 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 67808 on AAPC

Watch 67808

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REFERENCE DATA

Payers with rules4
Payers requiring prior auth4
  • Anthem BCBS · Effective October 19, 2026

    Prior authorization required

    Anthem local precertification/prior authorization list (Colorado | Anthem Blue Cross and Blue Shield | Commercial)

  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

  • Centene · Effective December 31, 2025

    Prior authorization required

    Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for 67808?

Anthem BCBS lists 67808 on Anthem local precertification/prior authorization list (Colorado | Anthem Blue Cross and Blue Shield | Commercial) for commercial plans (list dated October 19, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 67808?

CalViva Health lists 67808 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 Centene require prior authorization for 67808?

Centene lists 67808 on Sunshine Health Title XIX, Title XXI, Managed Medical Assistance 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 67808?

Community Health Plan of Imperial Valley lists 67808 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.

What insurance policy changes affect CPT 67808?

There are 3 tracked policy changes affecting CPT 67808, including updates from UnitedHealthcare. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 67808?

Payers that have issued tracked updates for CPT 67808 include: UnitedHealthcare.

How do I get notified when CPT 67808 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 67808. 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 67808?

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 67808

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 67808 in one place.

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