Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses

BCBS New Mexico · PayerPolicy · BCBSNM-DME103.007

Summary of the payer’s published policy. Not a coverage determination — confirm with BCBS New Mexico before submitting.

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Codes in this policy

Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
97799	CPT	Covered
S1040	HCPCS	Covered