Z00.110 Insurance Policy Changes

ICD-10 Z00.110 is officially defined as "Health examination for newborn under 8 days old." code Z00.110 is referenced in 5 tracked payer policy changes from Capital Blue Cross, Aetna, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code Z00.110 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Capital Blue Cross · Effective Mar 1, 2026High impact
AB2026-01-001 Updates and new information
Effective March 1, 2026, a number of codes newly require preauthorization for Commercial and Medicare Advantage members, including 20985, 22100 and 27860, and HCPCS code H0032 will be denied because the service is not provided directly to members. Codes C1605, C1721 and others no longer require preauthorization effective February 1, 2026, Evolent updated its CT, MRI, PET and cardiac imaging policies effective March 1, 2026, and TurningPoint accepts listed substitute codes for a limited group of musculoskeletal surgical procedures effective February 1, 2026. Effective for claims processed on or after March 1, 2026, facility claims with modifiers 59, XE, XP, XS and XU that do not meet the CMS criteria to bypass an NCCI procedure-to-procedure edit will be rejected, and physical medicine code 97140 is not separately reimbursed when billed with chiropractic manipulative treatment in the same anatomical region.
Aetna · Identified Oct 23, 2026Medium impact
Ocular Photoscreening (CPB 0689, reviewed 2026-10-15)
Aetna Clinical Policy Bulletin 0689 considers ocular photo-screening medically necessary for screening pre-verbal children up to 5 years of age, and children or adolescents who are non-cooperative or non-verbal, such as those with intellectual disability, developmental delay, or severe behavioral disorders. CPT 99174 and 99177 are covered if selection criteria are met, while CPT 0469T is listed as not covered for the indications in the policy. Aetna considers retinal birefringence scanning for detecting eye misalignment or strabismus experimental, investigational, or unproven.
Blue Cross and Blue Shield of Louisiana · Identified Jun 20, 2026Medium impact
Network News - 3rd Quarter 2022
Blue Cross and Blue Shield of Louisiana added HCPCS codes A9596, A9601, C9094, C9095, C9096, C9097, J0739, J1306, J1551, J2356, J2779, J2998, J3299, J9331, J9332, Q4259, Q4260 and Q4261 to its claims system effective July 1, 2022. For dates of service on and after August 15, 2022, the COVID-19 treatment bebtelovimab is reimbursed when billed with Modifier UC, which identifies the medication as commercially purchased, and the same administration codes are used for commercially purchased and government-supplied medication. Updated professional allowable charges for flu vaccination codes take effect for dates of service on and after November 1, 2022, and the new charges can be viewed in the Professional Provider Allowable Charges Search tool in iLinkBlue. FEP requires prior authorization for admission to residential treatment centers, and an administrative denial results if prior authorization is not obtained or the member is not enrolled in New Directions care management.
Health Net · Identified Jun 20, 2026Medium impact
20-552 Earn Incentives through the Prop 56 VBP Program
Health Net's Prop 56 Value-Based Payment (VBP) program pays add-on payments to Medi-Cal providers in Fresno, Kings and Madera counties for meeting specific measures in prenatal and postpartum care, early childhood care, chronic disease management and behavioral health integration. Payments apply to services performed on or after July 1, 2019, when submitted as a clean claim or encounter within one year from the date of service with a qualifying CPT and/or ICD-10 code. Payment amounts are higher for at-risk members, for example $70 for a prenatal care visit and $105 for an at-risk prenatal care visit, and $80 for diabetes care and $120 for at-risk diabetes care.
Health Net · Identified Jun 20, 2026Medium impact
20-554 Earn Incentives through the Prop 56 VBP Program
Health Net's Prop 56 Value-Based Payment (VBP) program pays add-on payments to Medi-Cal providers in Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus and Tulare counties for meeting specific measures in prenatal and postpartum care, early childhood care, chronic disease management and behavioral health integration. Payments apply to services performed on or after July 1, 2019, when submitted as a clean claim or encounter within one year from the date of service with a qualifying CPT and/or ICD-10 code. Payment amounts are higher for at-risk members, for example $70 for a prenatal care visit and $105 for an at-risk prenatal care visit, and $80 for diabetes care and $120 for at-risk diabetes care.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code Z00.110?

There are 5 tracked policy changes affecting code Z00.110, including updates from Capital Blue Cross, Aetna, Blue Cross and Blue Shield of Louisiana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code Z00.110?

Payers that have issued tracked updates for code Z00.110 include: Capital Blue Cross, Aetna, Blue Cross and Blue Shield of Louisiana, Health Net.

How do I get notified when code Z00.110 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code Z00.110. 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 code Z00.110?

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.

All billing codes J3590 C9399 J3490 99215 99213 99202

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AB2026-01-001 Updates and new information

Ocular Photoscreening (CPB 0689, reviewed 2026-10-15)

Network News - 3rd Quarter 2022

20-552 Earn Incentives through the Prop 56 VBP Program

20-554 Earn Incentives through the Prop 56 VBP Program

What insurance policy changes affect code Z00.110?

Which payers have updated policy for code Z00.110?

How do I get notified when code Z00.110 policy changes?

Why do payers change policies for code Z00.110?