Payer Policy Changes for Billing Teams

Policy	Payer	Type	Specialty	Date
Molecular and Proteomic Diagnostic Testing for Hematology and Oncology Indications - (0520) \| CIGNA Coverage Update	CIGNA	Modified	Oncology, Hematology	Apr 11, 2026
Elivaldogene Autotemcel (Skysona) \| AETNA Coverage Update	AETNA	Modified	Neurology & Neurosurgery	Apr 9, 2026
Routine Foot Care \| AETNA Coverage Update	AETNA	Modified	Podiatry	Apr 8, 2026
Ixabepilone (Ixempra) \| AETNA Coverage Update	AETNA	Modified	Oncology	Apr 8, 2026
Pre-Exposure Prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV) Prevention \| CMS Coverage Update	CMS	Modified	Infectious Disease	Apr 8, 2026
Cardiac Contractility Modulation (CCM) for Heart Failure (HF) \| CMS Coverage Update	CMS	Modified	Cardiology	Apr 8, 2026
Network Adequacy Provision (NAP) - (UM-20) \| CIGNA Coverage Update	CIGNA	Modified	General / Multi-Specialty	Apr 7, 2026
Eculizumab \| AETNA Coverage Update	AETNA	Modified	Hematology	Apr 2, 2026
Crovalimab-akkz (PiaSky) - 1064 \| AETNA Coverage Update	AETNA	Modified	Hematology	Apr 2, 2026
Nipocalimab-aahu (Imaavy) \| AETNA Coverage Update	AETNA	Modified	Rheumatology	Apr 2, 2026
Category III CPT Codes – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	General / Multi-Specialty	Apr 2, 2026
Experimental Procedures and Items, Investigational Devices, and Clinical Trials – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	General / Multi-Specialty	Apr 2, 2026
Medications/Drugs (Outpatient/Part B) – Medicare Advantage Medical Policy \| UHC Coverage Update	UHC	Modified	Pharmacy	Apr 2, 2026
Reflex Sympathetic Dystrophy Diagnosis \| AETNA Coverage Update	AETNA	Modified	Pain Management	Apr 1, 2026
Infusion Pumps \| AETNA Coverage Update	AETNA	Modified	DME & Home Health	Apr 1, 2026
Deep Brain Stimulation \| AETNA Coverage Update	AETNA	Modified	Neurology & Neurosurgery	Mar 28, 2026
Tumor Markers \| AETNA Coverage Update	AETNA	Modified	Oncology	Mar 28, 2026
Gout \| AETNA Coverage Update	AETNA	Modified	Rheumatology	Mar 28, 2026
Conversion of Anti-Coagulants to Heparin Before and After Elective Surgery — CPB 0200 \| AETNA Coverage Update	AETNA	Modified	Hematology	Mar 26, 2026
Enfuvirtide (Fuzeon) — CPB 0671 \| AETNA Coverage Update	AETNA	Modified	Infectious Disease	Mar 26, 2026
Renal Denervation (RDN) for Uncontrolled Hypertension — NCD 382 \| CMS Coverage Update	CMS	Modified	Urology & Nephrology	Mar 25, 2026
Breast Implant Removal — CPB 0142 \| AETNA Coverage Update	AETNA	Modified	General Surgery	Mar 20, 2026
Peak Flow Meters — CPB 0059 \| AETNA Coverage Update	AETNA	Modified	Pulmonology	Mar 19, 2026
Tracheostomy Supplies — CPB 0074 \| AETNA Coverage Update	AETNA	Modified	DME & Home Health	Mar 19, 2026
Orthognathic Surgery — CPB 0095 \| AETNA Coverage Update	AETNA	Modified	Dental	Mar 19, 2026

Payer policy changesfor billing and compliance teams.

One missed policy change can cost thousands in denied claims.

Payer policy changes
for billing and compliance teams.