Z48.23 Insurance Policy Changes

ICD-10 Z48.23 is officially defined as "Encounter for aftercare following liver transplant." code Z48.23 is referenced in 4 tracked payer policy changes from Blue Cross & Blue Shield of Mississippi and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code Z48.23 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Blue Cross & Blue Shield of Mississippi · Effective Jun 15, 2026Medium impact
Immunoglobulin Therapy
BCBSMS's Immunoglobulin Therapy policy states that prior authorization is required, and the 06/15/2026 update added Yimmugo to the products not covered on any BCBSMS Formulary. The same effective-dated update revised the medically necessary criteria for formulary intravenous and subcutaneous immunoglobulin therapy and changed the investigational list to specify sepsis in adults. Alyglo, Asceniv, Bivigam, Cuvitru, Flebogamma DIF, Gammagard S/D, Gammaplex, GamaSTAN, Hyqvia, Panzyga and Yimmugo are listed as not covered.
Aetna · Identified Oct 10, 2026Medium impact
Immune Globulins for Post-Exposure Prophylaxis (CPB 0544, reviewed 2026-10-07)
Aetna considers immune globulins medically necessary for hepatitis B, cytomegalovirus, Rho-D, rabies, varicella zoster, tetanus, vaccinia, botulism, hepatitis A, measles (rubeola) and rubella exposures or conditions, and considers all other indications experimental, investigational, or unproven. Each product has its own initial criteria, such as hepatitis B immune globulin for members who had contact with an individual diagnosed with hepatitis B virus, Rho-D immune globulin for unsensitized Rh-negative women at 24 to 28 weeks gestation unless the father is known to be Rh-negative, and varicella zoster immune globulin for high-risk individuals with significant exposure to varicella. Continuation of therapy for each product is considered medically necessary for all members, including new members, who meet all initial medical necessity criteria.
Aetna · Identified Aug 15, 2026Medium impact
Immune Globulins for Post-Exposure Prophylaxis (CPB 0544, reviewed 2025-12-23)
Reviewed 2025-12-23, Aetna Clinical Policy Bulletin 0544 covers immune globulin products for post-exposure prophylaxis and treatment, including hepatitis B, cytomegalovirus, Rho(D), rabies, varicella zoster, tetanus, measles, rubella, vaccinia, and botulism immune globulins. For each product the policy lists the indications it considers medically necessary and states that all other indications are experimental, investigational, or unproven. Continuation of therapy is considered medically necessary for all members, including new members, who meet the initial criteria. Immune globulin intramuscular injection (GamaSTAN) requires precertification.
Aetna · Identified Aug 14, 2026Medium impact
Near-Infrared Vascular Imaging and Near-Infrared Fluorescence Imaging (CPB 0846, reviewed 2025-12-04)
Aetna considers near-infrared vascular imaging and near-infrared fluorescence imaging experimental, investigational, or unproven for the indications listed in the policy. These include intra-operative fluorescence imaging of extra-hepatic bile ducts with indocyanine green for assessment of liver function, intra-parenchymal near-infrared spectroscopy for detection of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage, sentinel lymph node detection with indocyanine green in cutaneous melanoma and oral squamous cell carcinoma, and Cision InVision short-wave infrared imaging for pathological imaging. Other listed indications include diagnosis of peripheral artery disease, diagnosis of rheumatoid arthritis, sentinel lymph node mapping in endometrial cancer, transcutaneous NIR spectroscopy for monitoring kidney and liver allograft perfusion, and near-infrared vascular imaging systems for assessment of cutaneous wound and guiding vascular access.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code Z48.23?

There are 4 tracked policy changes affecting code Z48.23, including updates from Blue Cross & Blue Shield of Mississippi, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code Z48.23?

Payers that have issued tracked updates for code Z48.23 include: Blue Cross & Blue Shield of Mississippi, Aetna.

How do I get notified when code Z48.23 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code Z48.23. 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 Z48.23?

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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Immunoglobulin Therapy

Immune Globulins for Post-Exposure Prophylaxis (CPB 0544, reviewed 2026-10-07)

Immune Globulins for Post-Exposure Prophylaxis (CPB 0544, reviewed 2025-12-23)

Near-Infrared Vascular Imaging and Near-Infrared Fluorescence Imaging (CPB 0846, reviewed 2025-12-04)

What insurance policy changes affect code Z48.23?

Which payers have updated policy for code Z48.23?

How do I get notified when code Z48.23 policy changes?

Why do payers change policies for code Z48.23?