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Facet Arthroplasty
Blue Cross & Blue Shield of Mississippi·Orthopedics, Neurosurgery, Pain Management·Medical Policy
Effective date
May 16, 2024
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield updated their facet arthroplasty policy to classify all total facet arthroplasty procedures for lumbar spinal stenosis as investigational, meaning these procedures are not considered medically necessary and will likely be denied for coverage.
Action Required
Immediately: Billing team must stop billing CPT codes 0202T and 0719T for facet arthroplasty procedures as they are now classified as investigational and will be denied. Notify orthopedic and spine surgeons to discuss alternative treatment options with patients. Update encounter forms and billing system to flag these codes as non-covered. Consider obtaining advance beneficiary notices (ABNs) if patients still request these procedures.