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Orthopedic Services Procedure Codes

TurningPoint Healthcare Solutions, LLC (TurningPoint) performs Prior Authorization or Medical Necessity Determination reviews of the orthopedic services represented by the CPT® and HCPCS codes listed below as part of our Surgical and Implantable Device Management Program.

Please note that the orthopedic procedure codes listed below apply to the Surgical and Implantable Device Management Programs offered for both Horizon BCBSNJ and Horizon NJ Health patients.

This content was last revised on June 20, 2022 and may be subject to change.


0054T
0055T
0707T
20985
23130
23333
23334
23335
23410
23412
23415
23420
23470
23472
23473
23474
23616
23800
23802
24160
24164
24360
24361
24362
24363
24365
24366
24370
24371
25332
25441
25442
25443
25444
25445
25446
25800
25805
25810
25820
25825
27033
27090
27091
27120
27122
27125
27130
27132
27134
27137
27138
27236
27299
27403
27405
27407
27409
27412
27415
27416
27428
27429
27437
27438
27440
27441
27442
27443
27445
27446
27447
27486
27487
27488
27700
27702
27703
27704
27870
28446
29826
29827
29850
29851
29855
29856
29860
29861
29862
29863
29866
29867
29868
29870
29871
29873
29874
29875
29876
29877
29879
29880
29881
29882
29883
29884
29885
29886
29887
29888
29889
29899
29914
29915
29916
29999
G0289
J7330
S2112
S2118
S2900

Recent Changes

  • Procedure codes 0054T, 0055T, 20985 and S2900 are effective September 19, 2022 as part of this program.
  • Procedure code 0707T is effective January 1, 2022 as part of this program.
  • Procedure code 27630 has been removed from this program effective January 1, 2022.

TurningPoint Healthcare Solutions, LLC supports Horizon Blue Cross Blue Shield of New Jersey and Horizon NJ Health in the administration and utilization management review of certain surgical services that require the use of an implantable device for coverage. TurningPoint Healthcare Solutions, is independent from, and not affiliated with Horizon Blue Cross Blue Shield of New Jersey or the Blue Cross Blue Shield Association.

CPT® is a registered trademark of the American Medical Association.