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PAYER POLICY CHANGES

C1062 Insurance Policy Changes

HCPCS C1062 is officially defined as "Intravertebral body fracture augmentation with implant (e.g., metal, polymer)." HCPCS C1062 is referenced in 4 tracked payer policy changes from Capital Blue Cross, Excellus BlueCross BlueShield, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS C1062 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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REFERENCE DATA

Payers with rules10
Payers requiring prior auth10
  • BCBS Michigan · Effective October 13, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

  • Cigna · Effective March 7, 2026

    Prior authorization required

    Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs (EviCore)

  • Ambetter · Effective December 31, 2025

    Prior authorization required

    Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for C1062?

Ambetter lists C1062 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for C1062?

Arizona Complete Health lists C1062 on Arizona Complete Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for C1062?

BCBS Michigan lists C1062 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans, with conditions (list dated October 13, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for C1062?

CalViva Health lists C1062 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 Capital Blue Cross require prior authorization for C1062?

Capital Blue Cross lists C1062 on Capital Blue Cross single source preauthorization code list for commercial plans. Verify with the payer before scheduling.

What insurance policy changes affect HCPCS C1062?

There are 4 tracked policy changes affecting HCPCS C1062, including updates from Capital Blue Cross, Excellus BlueCross BlueShield, Regence BlueShield. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS C1062?

Payers that have issued tracked updates for HCPCS C1062 include: Capital Blue Cross, Excellus BlueCross BlueShield, Regence BlueShield, Indiana Medicaid (IHCP).

How do I get notified when HCPCS C1062 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS C1062. 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 HCPCS C1062?

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 C1062

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for C1062 in one place.

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