OpenPayer

This revision lists and organizes CPT and HCPCS/Codes related to services the payer designates in the policy text (Non-covered Experimental/Investigational Services). The document includes several new or highlighted codes effective on or after 01/01/2026 and an effective date for the policy of 2026-03-01.

Notable newly referenced or newly effective procedure codes in this revision include the intramedullary lengthening device codes: 0594T (humerus osteotomy with insertion of an externally controlled intramedullary lengthening device) and the related CPT numeric code 27713 (tibia osteotomy with insertion of an externally controlled intramedullary lengthening device), both identified as new code(s) effective 01/01/26. The policy text explicitly groups these with other musculoskeletal and implant-related codes addressed in the MDC 08: Orthopedics & Musculoskeletal section.

The policy text enumerates a broad set of CPT and HCPCS codes categorized within the Non-covered Experimental/Investigational Services document. Within musculoskeletal-related entries, key codes called out include intrafacet implant placement codes 0219T, 0220T, 0221T, and 0222T (posterior intrafacet implant[s] including imaging and bone graft or synthetic device placement for cervical, thoracic, lumbar, and additional segment levels), and 0737T (xenograft implantation into the articular surface — Agili-C implant).

Also listed is 0707T (injection(s) of bone-substitute material into subchondral bone defect with imaging guidance and arthroscopic assistance), and device/implant related HCPCS like C1737 (joint fusion and fixation device(s), sacroiliac and pelvis, including all system components — iFuse Bedrock Granite System implant). These inclusions indicate the policy’s focus on implants, bone-substitute procedures, and related musculoskeletal implant technologies within MDC 08.

The text specifically identifies procedures involving intramedullary lengthening devices and osteotomies. 0594T is described as "Osteotomy, humerus, with insertion of an externally controlled intramedullary lengthening device (PreciceSystem), including intraoperative imaging, initial and subsequent alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device." A related numeric CPT 27713 is listed for tibial osteotomy with insertion of an externally controlled intramedullary lengthening device, also noted as a new code effective 01/01/26.

These entries show the policy’s capture of contemporary limb-lengthening technologies and their procedural coding within the non-covered/exploratory list, aligning device-specific descriptors (e.g., PreciceSystem) with procedure codes.

The document consolidates a diverse set of advanced diagnostic, analytic, and device-specific services that are listed within the policy’s coding section. Examples include quantitative imaging and tissue characterization codes such as 0698T and 0722T (quantitative magnetic resonance and quantitative CT tissue characterization), bone-strength/fracture risk analytics (0743T, 0749T, 0750T), and software/AI-enabled analyses (e.g., 0731T FACE2GENE and assistive algorithmic ECG assessment codes 0764T/0765T).

Although these items span multiple specialties, their inclusion in this Non-covered/Experimental list signals payer scrutiny of advanced analytic, imaging-supplement, and AI-augmented services alongside orthopedics-specific procedures, reflecting an intersection between imaging/analysis technologies and musculoskeletal assessment.

The policy text contains multiple device and supply HCPCS entries and other related codes that supplement the musculoskeletal/implant entries. Examples include C1736 (catheter(s) for renal denervation — ultrasound), supply/component codes such as L5991 (addition to lower extremity prostheses, osseointegrated external prosthetic connector), and device-related codes tied to specific systems (e.g., L8608 for Argus II external component). These items appear alongside orthopedics-focused implants indicating the policy’s broader listing of investigational or non-covered technologies.

Additionally, the document reiterates that CPT and HCPCS code descriptions are copyright AMA and CMS respectively, and that several codes are listed as new or effective from 01/01/26, emphasizing code currency in the policy’s coding inventory.