Question 1

What insurance policy changes affect CPT 27428?

Accepted Answer

There are 2 tracked policy changes affecting CPT 27428, including updates from Providence Health Plan, Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Question 2

Which payers have updated policy for CPT 27428?

Accepted Answer

Payers that have issued tracked updates for CPT 27428 include: Providence Health Plan, Humana.

Question 3

How do I get notified when CPT 27428 policy changes?

Accepted Answer

Create a free account at PolicyChanges.app and save a search filtered to CPT 27428. You will receive a daily digest email whenever a new policy change references this code.

Question 4

Why do payers change policies for CPT 27428?

Accepted Answer

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

27428 Insurance Policy Changes

Special Alert March 2026 - Outpatient Surgical Site of Service Notice

Allograft Transplantation of the Knee - Medicare Advantage (Revised)