Blue Cross and Blue Shield of Minnesota policy
Orthognathic Surgery
Orthognathic Surgery is a public Blue Cross and Blue Shield of Minnesota policy (policy IV-16, effective Sep 28, 2026). It lists 36 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
- Policy number
- IV-16
- Effective
- Sep 28, 2026
- Line of business
- Commercial, Medicaid
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other Blue Cross and Blue Shield of Minnesota policies |
|---|---|
| 21120 | Policies naming 21120 |
| 21121 | Policies naming 21121 |
| 21122 | Policies naming 21122 |
| 21123 | Policies naming 21123 |
| 21125 | Policies naming 21125 |
| 21127 | Policies naming 21127 |
| 21141 | Policies naming 21141 |
| 21142 | Policies naming 21142 |
| 21143 | Policies naming 21143 |
| 21145 | Policies naming 21145 |
| 21146 | Policies naming 21146 |
| 21147 | Policies naming 21147 |
| 21150 | Policies naming 21150 |
| 21151 | Policies naming 21151 |
| 21154 | Policies naming 21154 |
| 21155 | Policies naming 21155 |
| 21159 | Policies naming 21159 |
| 21160 | Policies naming 21160 |
| 21188 | Policies naming 21188 |
| 21193 | Policies naming 21193 |
| 21194 | Policies naming 21194 |
| 21195 | Policies naming 21195 |
| 21196 | Policies naming 21196 |
| 21198 | Policies naming 21198 |
| 21199 | Policies naming 21199 |
| 21206 | Policies naming 21206 |
| 21208 | Policies naming 21208 |
| 21209 | Policies naming 21209 |
| D7941 | Policies naming D7941 |
| D7943 | Policies naming D7943 |
| D7944 | Policies naming D7944 |
| D7945 | Policies naming D7945 |
| D7946 | Policies naming D7946 |
| D7947 | Policies naming D7947 |
| D7948 | Policies naming D7948 |
| D7949 | Policies naming D7949 |