CommercialPrior AuthMedium impact
Reminder: Five New Codes Require Preauthorization Effective Feb. 1
EmblemHealth·Neurosurgery, Pain Management, Plastic Surgery·Prior Authorization
Effective date
Feb 1, 2022
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare are adding five new codes to their prior authorization requirements effective February 1st for Neurostimulators, Potentially Unproven Services, and Cosmetic & Reconstructive Surgery. Billing teams must identify these codes and update their prior authorization workflows to avoid claim denials.
Action Required
By February 1st: Billing team must access the full Preauthorization List Reductions and Updates for 2022 document from EmblemHealth and ConnectiCare to identify the five new codes requiring prior authorization. Update billing system rules and encounter forms to trigger prior auth requirements for these codes in Neurostimulator, Potentially Unproven Services, and Cosmetic & Reconstructive Surgery categories. Failure to obtain prior authorization will result in claim denials.