Payer Policy Changes for Billing Teams

Policy	Payer	Type	Specialty	Date
Panniculectomy and Abdominoplasty - (0027) \| CIGNA Coverage Update	CIGNA	Modified	General Surgery	Apr 13, 2026
Breast Implant Removal - (0048) \| CIGNA Coverage Update	CIGNA	Modified	General Surgery	Apr 13, 2026
Plantar Fasciitis Treatments - (0097) \| CIGNA Coverage Update	CIGNA	Modified	Podiatry	Apr 13, 2026
Surgical Treatments for Obstructive Sleep Apnea - (0158) \| CIGNA Coverage Update	CIGNA	Modified	Pulmonology	Apr 13, 2026
Scar Revision - (0328) \| CIGNA Coverage Update	CIGNA	Modified	Dermatology	Apr 13, 2026
Vitamin D Testing - (0526) \| CIGNA Coverage Update	CIGNA	Modified	Laboratory	Apr 13, 2026
Nivolumab Products (Opdivo, Opdivo Qvantig, and Opdualag) \| AETNA Coverage Update	AETNA	Modified	Oncology	Apr 11, 2026
Sinus Surgeries \| AETNA Coverage Update	AETNA	Modified	ENT / Otolaryngology	Apr 11, 2026
Follitropins and Menotropins \| AETNA Coverage Update	AETNA	Modified	OB/GYN	Apr 11, 2026
Genetic Testing for Reproductive Carrier Screening and Prenatal Diagnosis - (0514) \| CIGNA Coverage Update	CIGNA	Modified	OB/GYN, Laboratory, Primary Care	Apr 11, 2026
Molecular and Proteomic Diagnostic Testing for Hematology and Oncology Indications - (0520) \| CIGNA Coverage Update	CIGNA	Modified	Oncology, Hematology	Apr 11, 2026
Elivaldogene Autotemcel (Skysona) \| AETNA Coverage Update	AETNA	Modified	Neurology & Neurosurgery	Apr 9, 2026
Category III Current Procedural Terminology (CPT®) Codes - (0558) ---- future effective policy \| CIGNA Coverage Update	CIGNA	Modified	General / Multi-Specialty	Apr 9, 2026
Routine Foot Care \| AETNA Coverage Update	AETNA	Modified	Podiatry	Apr 8, 2026
Ixabepilone (Ixempra) \| AETNA Coverage Update	AETNA	Modified	Oncology	Apr 8, 2026
Peripheral Nerve Destruction for Pain Conditions - (0525) \| CIGNA Coverage Update	CIGNA	Modified	Pain Management	Apr 8, 2026
Pre-Exposure Prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV) Prevention \| CMS Coverage Update	CMS	Modified	Infectious Disease	Apr 8, 2026
Cardiac Contractility Modulation (CCM) for Heart Failure (HF) \| CMS Coverage Update	CMS	Modified	Cardiology	Apr 8, 2026
Network Adequacy Provision (NAP) - (UM-20) \| CIGNA Coverage Update	CIGNA	Modified	General / Multi-Specialty	Apr 7, 2026
Eculizumab \| AETNA Coverage Update	AETNA	Modified	Hematology	Apr 2, 2026
Crovalimab-akkz (PiaSky) - 1064 \| AETNA Coverage Update	AETNA	Modified	Hematology	Apr 2, 2026
Nipocalimab-aahu (Imaavy) \| AETNA Coverage Update	AETNA	Modified	Rheumatology	Apr 2, 2026
Category III CPT Codes – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	General / Multi-Specialty	Apr 2, 2026
Experimental Procedures and Items, Investigational Devices, and Clinical Trials – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	General / Multi-Specialty	Apr 2, 2026
Medications/Drugs (Outpatient/Part B) – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Pharmacy	Apr 2, 2026

Payer policy changesfor billing and compliance teams.

One missed policy change can cost thousands in denied claims.

Payer policy changes
for billing and compliance teams.