Does C1889 require prior authorization?

Yes, C1889 requires prior authorization (high confidence). At least one active policy explicitly requires prior authorization.

`C1889`, Implantable/insertable device, not otherwise classified

HCPCS/CPT

Prior Auth Required

At least one active policy explicitly requires prior authorization (high confidence)

For catheter ablation: documentation of symptomatic atrial fibrillation (paroxysmal or persistent) and that antiarrhythmic drugs have been ineffective, contraindicated, not tolerated or not preferred.
For catheter ablation in HFrEF: documentation of heart failure with reduced ejection fraction (HFrEF) with ejection fraction ≤ 40%.
For athlete indication: documentation supporting high-volume endurance athleticism defined as exercise of >45 metabolic equivalent-hours per week.
For pulmonary hypertension indication: documentation of pulmonary hypertension (PH) with pulmonary vascular disease and atrial fibrillation.

Cardiac catheter ablation with pulmonary vein isolation (Current Procedural Terminology [CPT®] codes 93656, 93657) is considered medically necessary for ANY of the following indications:
Symptomatic atrial fibrillation (paroxysmal or persistent) AND antiarrhythmic drugs have been ineffective, contraindicated, not tolerated or not preferred
Symptomatic atrial fibrillation (e.g., palpitations, chest pain, dyspnea) associated with heart failure and reduced ejection fraction (HFrEF) of ≤ 40%
An athlete* who develops atrial fibrillation with or without symptoms *high-volume endurance athleticism, defined as exercise of >45 metabolic equivalent-hours per week
Individual with or without symptoms with pulmonary hypertension (PH) with pulmonary vascular disease and atrial fibrillation
Repeat cardiac catheter ablation is considered medically necessary for an individual with recurrent symptomatic atrial fibrillation (American College of Cardiology Class 1 recommendation).

CIGNA-0469, Atrial Fibrillation: Nonpharmacological Treatments

EVICORE-HPLAN-CIGNA-AFCE721BA4F3, Cigna Comprehensive Code List - Effective 03/07/2026

EVICORE-HPLAN-CIGNA-FFF78083B324, Cigna Commercial Other Services Code List - Effective 03/07/2026

BCBSIL-SUR705.045, Annulus Closure After Discectomy

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