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PAYER POLICY CHANGES

L6920 Insurance Policy Changes

HCPCS L6920 is officially defined as "Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device." HCPCS L6920 is referenced in 1 tracked payer policy change from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS L6920 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 rules13
Payers requiring prior auth13
  • 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)

  • BCBS Arizona · Effective October 1, 2026

    Prior authorization required

    AZ Blue Standard Prior Authorization Requirements Code List (Updated 10/01/2026)

  • Colorado Medicaid · Effective July 1, 2026

    Prior authorization required

    Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column)

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for L6920?

Ambetter lists L6920 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 AmeriHealth Caritas require prior authorization for L6920?

AmeriHealth Caritas lists L6920 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for L6920?

Anthem BCBS lists L6920 on List of items and services that require prior authorization (Medicare) for medicare advantage plans (list dated February 11, 2026). Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for L6920?

Arizona Complete Health lists L6920 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 Arizona require prior authorization for L6920?

BCBS Arizona lists L6920 on AZ Blue Standard Prior Authorization Requirements Code List (Updated 10/01/2026) for commercial plans (list dated October 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS L6920?

There are 1 tracked policy change affecting HCPCS L6920, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS L6920?

Payers that have issued tracked updates for HCPCS L6920 include: Aetna.

How do I get notified when HCPCS L6920 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS L6920. 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 L6920?

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 L6920

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for L6920 in one place.

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