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.

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.