What insurance policy changes affect CPT 77078?

There are 11 tracked policy changes affecting CPT 77078, including updates from Health Net, Sentara Health Plans, Ambetter. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 77078?

Payers that have issued tracked updates for CPT 77078 include: Health Net, Sentara Health Plans, Ambetter, Aetna, Blue Cross Blue Shield of Nebraska, Blue Cross Blue Shield of Rhode Island.

How do I get notified when CPT 77078 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 77078. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 77078?

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.

77078 — A CT scan that measures bone strength and density in the spine and central body areas.: Insurance Policy Changes

77078 Insurance Policy Changes

CPT 77078, in plain terms, covers A CT scan that measures bone strength and density in the spine and central body areas. CPT 77078 is referenced in 11 tracked payer policy changes from Health Net, Sentara Health Plans, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 77078 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

Bone Mass Measurements (CPB 0134, reviewed 2026-03-19)

Aetna·Effective Mar 19, 2026

Aetna updated its bone mass measurement policy (CPB 0134, reviewed 2026-03-19) to clarify covered indications, establish frequency limits (typically not more than once every 2 years), and explicitly exclude experimental technologies including finite element analysis (CPT 0554T-0557T, 0743T), deep learning-based QCT, cone beam CT, REMS (CPT 0815T), and AI-assisted vertebral fracture detection software. Billing teams must immediately stop billing excluded codes and enforce frequency restrictions in their authorization workflows.

77078 Insurance Policy Changes

26-253 Evolent Removes Prior Authorization for Select Radiology and Cardiology Services

Authorization Updates - Effective May 1, 2026

Q1 2026 Provider Newsletter

Complex Regional Pain Syndrome (CRPS): Diagnosis (CPB 0147, reviewed 2026-03-30)

Bone Mass Measurements (CPB 0134, reviewed 2026-03-19)

MPC November 2025

MPC November 2025

Biochemical Markers of Bone Remodeling (CPB 0562, reviewed 2025-08-22)

26-254 Evolent Removes Prior Authorization for Select Radiology and Cardiology Services

26-255 Evolent Removes Prior Authorization for Select Radiology and Cardiology Services

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