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Fast Facts Newsletter - January 2026

HealthPartners·Gastroenterology, Urology, Plastic Surgery +3 more·Pharmacy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Days to comply

Summary

HealthPartners January 2026 newsletter includes multiple policy updates: several medical services added to non-covered/investigational list, surgical treatments for lipedema/lymphedema criteria updated for clarity, and waterjet ablation for BPH no longer requires prior medication trial.

Action Required

Action needed
Immediately: Update billing system to flag CPT codes 0397T, C9797, C8004, C1982, 0483T, 0484T and HCPCS codes Q4278, Q4275, Q4272, Q4273, Q4274, Q4303, Q4302, Q4270, Q4271, Q4297, Q4239 as non-covered/investigational services. Update lipedema/lymphedema billing documentation requirements to include bilateral symmetric nodular fat deposit confirmation and color photographs. Remove medication trial requirement for waterjet ablation (aquablation) BPH procedures.

Affected Billing Codes

C9797
C8004
C1982
Q4278
Q4275
Q4272
Q4273
Q4274
Q4303
Q4302
Q4270
Q4271
Q4297
Q4239