What insurance policy changes affect CPT 70472?

There are 10 tracked policy changes affecting CPT 70472, including updates from CareSource, Medical Mutual of Ohio, Blue Cross Blue Shield of Massachusetts. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 70472?

Payers that have issued tracked updates for CPT 70472 include: CareSource, Medical Mutual of Ohio, Blue Cross Blue Shield of Massachusetts, Aetna, UnitedHealthcare, Harvard Pilgrim Health Care.

How do I get notified when CPT 70472 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 70472. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 70472?

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.

70472 — A CT scan of the brain with analysis, including additional imaging with contrast dye to visualize blood vessels.: Insurance Policy Changes

70472 Insurance Policy Changes

CPT 70472, in plain terms, covers A CT scan of the brain with analysis, including additional imaging with contrast dye to visualize blood vessels. CPT 70472 is referenced in 10 tracked payer policy changes from CareSource, Medical Mutual of Ohio, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 70472 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

Tourette's Syndrome (CPB 0480, reviewed 2026-07-24)

Aetna·Effective Jul 24, 2026

Aetna updated its Tourette's Syndrome clinical policy (CPB 0480) establishing medical necessity criteria and clearly delineating covered versus experimental/investigational treatments. Covered services include behavioral intervention (CBIT), specific pharmacotherapies, psychotherapy, and limited assessment tools (EEG/neuro consult only with focal signs). Most advanced interventions including deep brain stimulation, transcranial stimulation, neuroimaging, and biomarker testing are classified as experimental and not covered. Billing teams must immediately align claims submission and prior authorization processes to this framework.

70472 Insurance Policy Changes

[Georgia] Prior Authorization Requirement Update

Mutual News May 2026 Newsletter

Medical Policy Updates for June 2026

Cerebral Perfusion Studies (CPB 0663, reviewed 2026-04-14)

[Georgia] Prior Authorization Requirement Update

New radiology and cardiology prior authorization codes

Tourette's Syndrome (CPB 0480, reviewed 2026-07-24)

[Ohio] Prior Authorization Requirement Update

Point32Health Medical Necessity Guideline updates

New radiology and cardiology prior authorization codes