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PAYER POLICY CHANGES

C9796 Insurance Policy Changes

HCPCS C9796 is officially defined as "Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa [sis])." No tracked policy changes reference HCPCS C9796 yet. New payer updates are added daily, so check back soon or create a free alert to be notified the moment a change affects this code.

No policies yet

No tracked policy changes match this filter yet. New policies are added daily.

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REFERENCE DATA

Payers with rules5
Payers requiring prior auth5
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • 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)

  • Elevance Health · Effective February 11, 2026

    Prior authorization required

    List of items and services that require prior authorization (Medicaid GA)

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for C9796?

Anthem BCBS lists C9796 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for C9796?

BCBS Michigan lists C9796 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 C9796?

CalViva Health lists C9796 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 Community Health Plan of Imperial Valley require prior authorization for C9796?

Community Health Plan of Imperial Valley lists C9796 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.

Does Elevance Health require prior authorization for C9796?

Elevance Health lists C9796 on List of items and services that require prior authorization (Medicaid GA) for medicaid managed plans (list dated February 11, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS C9796?

No policy changes affecting HCPCS C9796 have been tracked yet. Check back as coverage expands.

Which payers have updated policy for HCPCS C9796?

No payer-specific updates have been tracked for HCPCS C9796 yet.

How do I get notified when HCPCS C9796 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS C9796. 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 C9796?

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 C9796

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for C9796 in one place.

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