What insurance policy changes affect code B99.9?

There are 3 tracked policy changes affecting code B99.9, including updates from Aetna, Colorado Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code B99.9?

Payers that have issued tracked updates for code B99.9 include: Aetna, Colorado Medicaid.

How do I get notified when code B99.9 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code B99.9. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code B99.9?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

PAYER POLICY CHANGES

B99.9 Insurance Policy Changes

ICD-10 B99.9 is officially defined as "Unspecified infectious disease." code B99.9 is referenced in 3 tracked payer policy changes from Aetna and Colorado Medicaid. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code B99.9 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Sep 29, 2026Medium impact
Adoptive Immunotherapy and Cellular Therapy (CPB 0641, reviewed 2026-09-25)
Aetna considers adoptive immunotherapy using tumor-infiltrating lymphocytes (TILs) or interleukin-2 activated lymphokine-activated killer (LAK) cells experimental, investigational or unproven for a long list of indications, including Alzheimer disease, esophageal, gynecologic, head and neck, hepatocellular, lung, glioblastoma, renal cell, pancreatic and other malignancies, because there is not adequate evidence that it is more beneficial than IL-2 alone. Melanoma is excluded from that list for lifileucel (Amtagvi), an FDA-approved TIL therapy. Cellular therapy (including embryonic cell, fresh cell, glandular, live cell, MAGE-A4 cell, organotherapy and xenotransplant therapy) is considered experimental, investigational or unproven for a long list of indications due to lack of adequate evidence, including angina, arthritis, diabetes, heart failure, hypertension, ischemic heart disease, ischemic stroke, motor neuron diseases, osteoarthritis and focal cartilage defects of the knee, peripheral arterial disease, and traumatic brain injury. Cancer is excluded from that list for afamitresgene autoleucel (Tecelra), an FDA-approved MAGE-A4-directed TCR T-cell therapy for synovial sarcoma. The policy also lists CAR T-cell therapy for solid tumors and virus-specific T-cell lymphocyte therapy for viral infections as experimental, investigational or unproven. HCPCS code S2107 (adoptive immunotherapy per course of treatment) and M0075 (cellular therapy) are listed as not covered for the indications in the policy.
Aetna · Identified Aug 16, 2026Medium impact
Intermittent Intravenous Insulin Therapy (CPB 0742, reviewed 2025-11-26)
Aetna considers intermittent intravenous insulin therapy experimental, investigational, or unproven for diabetes mellitus and all other indications. This covers the therapy under its other names, including hepatic activation therapy, metabolic activation therapy, physiologic insulin re-sensitization (PIR) infusions, pulse insulin therapy, and the Trina Health artificial pancreas treatment. Aetna also considers insulin potentiation therapy experimental for arthritis, cancer, infectious diseases, and other conditions, and considers blood glucose, potassium, respiratory quotient, and urine urea nitrogen tests experimental when performed in the context of intermittent intravenous insulin therapy. The policy does not apply to insulin infusions for diabetic ketoacidosis or hyperosmolar coma.
Colorado Medicaid · Identified Jun 20, 2026Medium impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2200475 - 02/2022)
The February 2022 Health First Colorado provider bulletin (B2200475) covers several changes. Effective February 1, 2022, claims requiring electronic visit verification (EVV) go through pre-payment review, and claims without the needed EVV records may deny with EOB 3054. The bulletin also describes at-home OTC COVID-19 test billing under HCPCS E1399 with modifier U1 from January 15, 2022, requires the ordering provider's NPI on DMEPOS claims effective July 1, 2022, and notes that 24 physician-administered drug codes became subject to prior authorization effective January 18, 2022.

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Adoptive Immunotherapy and Cellular Therapy (CPB 0641, reviewed 2026-09-25)

Intermittent Intravenous Insulin Therapy (CPB 0742, reviewed 2025-11-26)

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2200475 - 02/2022)

What insurance policy changes affect code B99.9?

Which payers have updated policy for code B99.9?

How do I get notified when code B99.9 policy changes?

Why do payers change policies for code B99.9?