Date Posted: 10/02/2025
The following codes are being added to our preauthorization list effective Jan. 13, 2026.
Codes Being Added To The Preauthorization List Starting Jan. 13, 2026
| CPT/HCPCS Code | CPT Code Description |
|---|---|
A4421 |
Ostomy supply; miscellaneous |
A5507 |
For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe |
A6261 |
Wound filler, gel/paste, per fluid ounce, not otherwise specified |
A6262 |
Wound filler, dry form, per gram, not otherwise specified |
A6512 |
Compression burn garment, not otherwise classified |
A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
A9901 |
DME delivery, set up, and/or dispensing service component of another HCPCS code |
L0999 |
Addition to spinal orthosis, not otherwise specified |
L3649 |
Orthopedic shoe, modification, addition or transfer, not otherwise specified |
The following codes are being removed from our preauthorization list effective Jan. 1, 2026.
Codes Removed From Preauthorization List Starting Jan. 1, 2026
| CPT/HCPCS Code | CPT Code Description |
|---|---|
0540U |
Transplantation medicine, quantification of donor-derived cell-free DNA using next-generation sequencing analysis of plasma, reported as percentage of donor-derived cell-free DNA to determine probability of rejection |
81479 |
Unlisted molecular pathology procedure [when specified as gene analysis of V600K variant] |
81595 |
Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported as a rejection risk score |
JP 56610 10/25