What insurance policy changes affect CPT 92928?

There are 12 tracked policy changes affecting CPT 92928, including updates from UnitedHealthcare, Highmark, Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 92928?

Payers that have issued tracked updates for CPT 92928 include: UnitedHealthcare, Highmark, Humana, Aetna, Independence Blue Cross.

How do I get notified when CPT 92928 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 92928. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 92928?

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.

92928 — Your eye doctor performed imaging to check blood vessel health in your retina using a special dye injection.: Insurance Policy Changes

92928 Insurance Policy Changes

CPT 92928, in plain terms, covers Your eye doctor performed imaging to check blood vessel health in your retina using a special dye injection. CPT 92928 is referenced in 12 tracked payer policy changes from UnitedHealthcare, Highmark, and 3 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 92928 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

MA11.056i, Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery

Independence Blue Cross·Effective Jan 1, 2026

Independence Blue Cross MA11.056i policy on Percutaneous Transluminal Angioplasty (PTA) with carotid stenting has been reissued with annual updates to CPT/HCPCS codes effective January 1, 2026. Seven CPT codes were revised, five new codes were added (37254-37261, 37263-37278, 37280-37299, 92930, 92945), and seven codes were terminated (37220-37235, 92921, 92925, 92929, 92934, 92938, 92944). Coverage criteria remain unchanged but billing teams must update systems to reflect these code transitions.

92928 Insurance Policy Changes

Percutaneous Coronary Interventions

Prior Authorization Changes: One Code Added and Nine Removed

Percutaneous Coronary Intervention - Medicare Advantage (Revised)

Drug-Eluting Stents (CPB 0621, reviewed 2026-02-25)

Percutaneous Coronary Intervention - Medicare Advantage (Revised)

MA03.003r, Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service

MA11.113m, Percutaneous Coronary Intervention, Coronary Angiography, and Arterial Ultrasound

MA11.056i, Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery

03.00.06ad, Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service

11.02.27m, Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound (Independence)

Drug-Eluting Stents (CPB 0621, reviewed 2026-09-23)

Remote Ischemic Conditioning (CPB 0814, reviewed 2025-11-20)