MedicaidPrior AuthLow impact
Prior Authorization Requirement Updated for Procedure Code 19330
Nevada Medicaid·NV · Plastic Surgery, General Surgery, Oncology·Prior Authorization
Effective date
Dec 29, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has removed the prior authorization requirement for CPT code 19330 (Removal Ruptured Breast Implant) when billed with a breast cancer diagnosis code, effective December 29, 2025. This change applies to multiple provider types including physicians, hospitals, and surgical centers.
Action Required
Immediately: Billing team must update Nevada Medicaid billing rules to remove prior authorization requirements for CPT 19330 when paired with breast cancer diagnosis codes. Update billing software and notify providers that prior auth is no longer needed for this specific combination. This only applies to Nevada Medicaid claims.