If you are a NY provider that accepts Healthfirst members, then the blog post is for you!

Starting 10/1/26 there will be new codes that will become effective and will require and auth.

Codes that will require an auth through Healthfirst firecty:

• 0935T CPT-CAT III
  Cystourethroscopy with renal pelvic
  sympathetic denervation,
  radiofrequency ablation, retrograde ureteral approach,
  including insertion of guide wire, selective placement of
  ureteral sheath(s) and multiple conformable electrodes,
  contrast injection(s), and fluoroscopy, bilateral
• 86890 CPT-CAT I
  Autologous blood or component, collection processing
  and storage; predeposited
• 86891 CPT-CAT I
  Autologous blood or component, collection processing
  and storage; intra- or postoperative salvage

The codes that will be managed by EviCore:

• A9607
  HCPCS
  Level II
  Lutetium Lu 177 vipivotide tetraxetan, therapeutic
• A9699
  HCPCS
  Level II
  Radiopharmaceutical, therapeutic, not otherwise
  classified
• 77423 CPT-CAT I
  High energy neutron radiation treatment delivery, 1 or
  more isocenter(s) with coplanar or non-coplanar
  geometry with blocking and/or wedge, and/or
  compensator(s)

Please remember that patient benefits still apply when it comes to coverage of the services.

Fins thia information useful? Follow my blog for more!

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