CommercialBilling CodesMedium impact
Reminder: CPT and HCPCS Billing Guidelines
EmblemHealth·Plastic Surgery, General Surgery·Reimbursement
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare are reinforcing their policy to reject HCPCS codes S2066-S2068 for free flap breast reconstruction procedures. Providers must use CPT code 19364 instead, as it now adequately describes the GAP, DIEP, and SIEA flap techniques previously covered by the temporary HCPCS codes.
Action Required
Immediately: Billing team must update system rules to use CPT code 19364 for all free flap breast reconstruction procedures (GAP, DIEP, and SIEA flaps) for EmblemHealth and ConnectiCare plans. Remove HCPCS codes S2066-S2068 from billing options for these payers. Update encounter forms and notify surgeons that claims submitted with the HCPCS codes will be rejected.