Coverage policy updates

Policy changes Backwork has recorded, newest first. The most recent change on record is from October 24, 2026. Changes appear here after Backwork reviews and applies a refresh, so this page can trail the payers’ own sites.

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

Recorded changes

86,510 on record

Recorded policy changes, newest first
Recorded	Payer	Policy	Change
May 8, 2026	CMS / Medicare	Billing and Coding: Hyaluronans Intra-articular Injections ofArticle · A52420	Codes changed
May 8, 2026	CMS / Medicare	Billing and Coding: Denosumab (ProliaÂ®, XgevaÂ®, JubbontiÂ®) and biosimilarsArticle · A52399	Codes changed
May 8, 2026	CMS / Medicare	Billing and Coding: CPT Code 87641 (Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique)Article · A52379	Codes changed
May 8, 2026	CMS / Medicare	Billing and Coding: Bevacizumab and biosimilarsArticle · A52370	Codes changed
May 8, 2026	CMS / Medicare	Billing and Coding: Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee â Medical Policy ArticleArticle · A52369	Codes changed
Jan 13, 2026	UnitedHealthcare	Radiologic Diagnostic ProceduresMedical Policy · UHC-POL-radiologic-diagnostic-procedures	Created
Jan 13, 2026	UnitedHealthcare	Prior authorization and notification \| UHCprovider.comMedical Policy · UHC-POL-prior-authorization-and-notification	Created
Jan 13, 2026	UnitedHealthcare	Clinical Pharmacy and Specialty Drugs Prior Authorization ...Drug Policy · UHC-POL-clinical-pharmacy-and-specialty-drugs-prior-authorization	Created
Jan 13, 2026	UnitedHealthcare	Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes – Commercial and Individual Exchange Medical PolicyMedical Policy · UHC-POL-continuous-glucose-monitoring-and-insulin-delivery-for	Created
Jan 13, 2026	UnitedHealthcare	Uterine Services and ProceduresMedical Policy · UHC-POL-uterine-services-and-procedures	Created
Jan 13, 2026	CMS / Medicare	The LCD Development ProcessLCD · LCD-the-lcd-development-process	Created
Jan 13, 2026	Humana	Find Prior Authorization Guidelines and FormsClinical Guideline · HUMANA-find-prior-authorization-guidelines-and-forms	Created
Jan 13, 2026	CMS / Medicare	MCD SearchNCD · CMS-mcd-search	Created
Jan 13, 2026	CMS / Medicare	NCA - Implantable Defibrillators (CAG-00157R2)NCD · CMS-nca-implantable-defibrillators-cag-00157r2	Created
Jan 13, 2026	CMS / Medicare	MM14149 - National Coverage Determination 20.37: Transcatheter Tricuspid Valve ReplacementNCD · CMS-mm14149-national-coverage-determination-2037-transcatheter	Created
Jan 13, 2026	CMS / Medicare	Medicare Program Integrity Manual, Chapter 13NCD · CMS-medicare-program-integrity-manual-chapter-13	Created
Jan 13, 2026	CMS / Medicare	Local Coverage Determination Process and TimelineLCD · CMS-local-coverage-determination-process-and-timeline	Created
Jan 13, 2026	CMS / Medicare	Medicare Program Integrity ManualNCD · CMS-medicare-program-integrity-manual	Created
Jan 13, 2026	CMS / Medicare	MM10865Article · CMS-mm10865	Created
Jan 13, 2026	CMS / Medicare	NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3)NCD · CMS-nca-cardiac-pacemakers-single-chamber-and-dual-chamber	Created
Jan 13, 2026	CMS / Medicare	Local Coverage Final LCDs by State Report ResultsLCD · CMS-local-coverage-final-lcds-by-state-report-results	Created
Jan 13, 2026	CMS / Medicare	Medicare Claims Processing ManualNCD · CMS-medicare-claims-processing-manual	Created
Jan 13, 2026	CMS / Medicare	Coverage \| CMSNCD · CMS-coverage	Created
Jan 13, 2026	CMS / Medicare	NCA - Implantable Defibrillators (CAG-00157R3)NCD · CMS-nca-implantable-defibrillators-cag-00157r3	Created
Jan 13, 2026	CMS / Medicare	MM12290NCD · CMS-mm12290	Created
Jan 13, 2026	CMS / Medicare	NCA - Implantable Cardioverter Defibrillators (ICDs) (CAG-00157N)NCD · CMS-nca-implantable-cardioverter-defibrillators-icds-cag-00157n	Created
Jan 13, 2026	CMS / Medicare	NCA - Implantable Cardioverter Defibrillators (CAG-00157R4)NCD · CMS-nca-implantable-cardioverter-defibrillators-cag-00157r4	Created
Jan 13, 2026	CMS / Medicare	Medicare Coverage Determination ProcessNCD · CMS-medicare-coverage-determination-process	Created
Jan 13, 2026	CMS / Medicare	Local Coverage DeterminationsLCD · CMS-local-coverage-determinations	Created
Jan 13, 2026	CMS / Medicare	Medicare National Coverage Determinations ManualNCD · CMS-medicare-national-coverage-determinations-manual	Created
Jan 13, 2026	CMS / Medicare	Implantable Cardioverter DefibrillatorsNCD · CMS-implantable-cardioverter-defibrillators	Created
Jan 13, 2026	Cigna	What is Prior Authorization in Health Insurance?Medical Policy · CIGNA-what-is-prior-authorization-in-health-insurance	Created
Jan 13, 2026	Cigna	Precertifications and Prior AuthorizationsMedical Policy · CIGNA-precertifications-and-prior-authorizations	Created
Jan 13, 2026	Anthem	CG-SURG-83Medical Policy · ANTHEM-cg-surg-83	Created
Jan 13, 2026	Anthem	Medical Policies & Clinical UM GuidelinesClinical Guideline · ANTHEM-medical-policies-clinical-um-guidelines	Created
Jan 13, 2026	Anthem	Clinical CriteriaClinical Guideline · ANTHEM-clinical-criteria	Created
Jan 13, 2026	Anthem	CG-MED-59Medical Policy · ANTHEM-cg-med-59	Created
Jan 13, 2026	Anthem	CG-MED-74 Implantable Ambulatory Event Monitors and Mobile Cardiac TelemetryMedical Policy · ANTHEM-cg-med-74-implantable-ambulatory-event-monitors-and-mobile	Created
Jan 13, 2026	Anthem	CG-MED-34Medical Policy · ANTHEM-cg-med-34	Created
Jan 13, 2026	Anthem	CG-SURG-79 Implantable Infusion PumpsMedical Policy · ANTHEM-cg-surg-79-implantable-infusion-pumps	Created
Jan 13, 2026	Anthem	CG-MED-83Medical Policy · ANTHEM-cg-med-83	Created
Jan 13, 2026	Aetna	Pembrolizumab (Keytruda)Clinical Guideline · AETNA-pembrolizumab-keytruda-medical-clinical-policy-bulletins	Created
Jan 13, 2026	Aetna	2026 Advanced Control Plan - AetnaMedical Policy · AETNA-2026-advanced-control-plan-aetna	Created
Jan 13, 2026	Aetna	Fam-trastuzumab Deruxtecan-nxki (Enhertu)Clinical Guideline · AETNA-fam-trastuzumab-deruxtecan-nxki-enhertu-medical-clinical	Created
Jan 13, 2026	Aetna	GoutClinical Guideline · AETNA-gout-medical-clinical-policy-bulletins	Created
Jan 13, 2026	Aetna	Aetna Medicare Part B Drug CriteriaDrug Policy · AETNA-aetna-medicare-part-b-drug-criteria	Created
Jan 13, 2026	Aetna	Venous Stenting for the Treatment of Idiopathic Intracranial HypertensionClinical Guideline · AETNA-venous-stenting-for-the-treatment-of-idiopathic	Created
Jan 13, 2026	Aetna	OxygenClinical Guideline · AETNA-oxygen-medical-clinical-policy-bulletins	Created
Jan 13, 2026	Aetna	EculizumabClinical Guideline · AETNA-eculizumab-medical-clinical-policy-bulletins	Created
Jan 13, 2026	Aetna	Obstructive Sleep Apnea in AdultsClinical Guideline · AETNA-obstructive-sleep-apnea-in-adults-medical-clinical-policy	Created