CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · General Surgery, Gastroenterology·Medical Policy
Effective date
Apr 15, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross expanded coverage for bariatric surgery to include Single anastomosis duodeno-ileal (SADI) bypass with sleeve gastrectomy (CPT 43659) under restricted criteria. Additionally, six medical policies covering various treatments will be archived, meaning these services will no longer have specific coverage guidelines.
Action Required
By April 15, 2026: Billing team must update prior authorization processes for CPT 43659 to include new SADI bypass coverage criteria including BMI requirements, comorbidity documentation, and pre-operative program completion. Review archived policies for Chemical Ecology, Opioid Detoxification under Heavy Sedation, Positional MRI, Orthopedic Stem Cell Therapy, Multispectral Digital Skin Lesion Analysis, and Dry Hydrotherapy to understand coverage changes after archival date.