Update: Outpatient Surgery Site of Care Medical Policies
- WPA/NEPA
- CPA/SEPA
- DE
- WV
Tue, Jan 13, 2026
Effective Jan. 12, 2026, Highmark removed procedure codes from Commercial Medical Policy (MP) Z-109 and Medicare Advantage MP Z-129, both of which cover Outpatient Surgery Site of Care. The appropriate codes were removed from the Delaware, Pennsylvania, and West Virginia versions of these policies.
Following is a list of the codes that have been removed:
21089 |
21110 |
22513 |
22514 |
22515 |
22551 |
22552 |
22558 |
22585 |
22600 |
22612 |
22614 |
22630 |
22633 |
22634 |
22840 |
22842 |
22845 |
22846 |
22853 |
22854 |
22856 |
22858 |
22870 |
22899 |
23000 |
23020 |
23120 |
23130 |
23410 |
23412 |
23415 |
23420 |
23430 |
23440 |
23450 |
23455 |
23462 |
23470 |
23472 |
27096 |
27130 |
27279 |
27403 |
27412 |
27415 |
27416 |
27418 |
27420 |
27422 |
27427 |
27428 |
27438 |
27446 |
27447 |
27599 |
28110 |
28291 |
28295 |
28296 |
28297 |
28299 |
28306 |
28322 |
28755 |
29805 |
29806 |
29807 |
29819 |
29820 |
29821 |
29822 |
29823 |
29824 |
29825 |
29826 |
29827 |
29828 |
29860 |
29861 |
29862 |
29863 |
29870 |
29873 |
29874 |
29875 |
29876 |
29877 |
29879 |
29880 |
29881 |
29882 |
29883 |
29884 |
29885 |
29886 |
29887 |
29888 |
29889 |
29892 |
29899 |
29914 |
29915 |
29916 |
29999 |
0275T |
62320 |
62321 |
62322 |
62323 |
62350 |
62362 |
62380 |
63030 |
63035 |
63042 |
63056 |
63650 |
63655 |
63685 |
64479 |
64480 |
64483 |
64484 |
64490 |
64491 |
64492 |
64493 |
64494 |
64495 |
64510 |
64520 |
64633 |
64634 |
64635 |
64636 |
C9757 |
G0260 |
|
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To access the updated MP Z-109 or MP Z-129, go to the Medical Policies page on the Provider Resource Center (PRC). Scroll down to the search site for Commercial or Medicare Advantage, choose your region, and type the policy into the search bar.
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The Medical Policy Update newsletter is a monthly publication that focuses only on medical policy and claims administration updates, including coding guidelines and procedure code revisions.
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