11420 CPT® code: payer coverage and prior authorization2 of 2 payer prior-auth lists that name 11420 require prior authorization or set conditions: Neighborhood Health Partnership, UnitedHealthcare.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Neighborhood Health Partnership | Neighborhood Health Partnership | FL | prior auth under conditions | site of care: outpatient hospital, ASC; not in AK, IL, GU, MA, PR, RI, TX, UT, VI, WI | Sep 1, 2026 | Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026 |
| UnitedHealthcare | UnitedHealthcare Complete (Individual & Family plans) | All | prior auth under conditions | site of care: outpatient hospital, ASC | Sep 1, 2026 | Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026 |
11420 appears in 12 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, Centene, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Actinic Keratoses Treatments (0567) | covered if criteria are met | Aug 21, 2026 | payer document |
| Aetna | Benign Skin Lesion Removal (0633) | covered if criteria are met (range 11400-11446) | Sep 9, 2026 | payer document |
| Aetna | Cosmetic Surgery and Procedures (0031) | covered if criteria are met (range 11400-11446) | Jun 25, 2026 | payer document |
| Aetna | Lymphangioma and Infantile Hemangioma (0817) | covered if criteria are met (range 11400-11446) | Dec 3, 2025 | payer document |
| Aetna | Skin and Soft Tissue Substitutes (0244) | not covered (range 10040-19499) | Jul 29, 2026 | payer document |
| Anthem | Treatment of Keloids and Scar Revision (CG-SURG-31) | covered if criteria are met (range 11400-11446) | May 14, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Removal Of Benign Skin Lesions And Scars (L.7.01.412) | covered if criteria are met | payer document | |
| Blue Cross Blue Shield of Massachusetts | Benign Skin Lesions (707) | covered if criteria are met | payer document | |
| Blue Shield of California | BSC7.08 | Cosmetic and Reconstructive Procedures | listed, no stance | payer document | |
| Centene | Cosmetic and Reconstructive Procedures Reference Number: CP.MP.31 (CP.MP.31) | covered if criteria are met | Aug 1, 2026 | payer document |
| Regence | Surgical Site of Care – Hospital Outpatient (Utilization Management 19) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Office-Based Procedures – Site of Service (MP.12.22) Dermatology | listed, no stance | Jul 1, 2026 | payer document |
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.