What insurance policy changes affect code D07.1?

There are 3 tracked policy changes affecting code D07.1, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code D07.1?

Payers that have issued tracked updates for code D07.1 include: Aetna.

How do I get notified when code D07.1 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code D07.1. 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 D07.1?

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

D07.1 Insurance Policy Changes

ICD-10 D07.1 is officially defined as "Carcinoma in situ of vulva." code D07.1 is referenced in 3 tracked payer policy changes from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code D07.1 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Aug 18, 2026Medium impact
Laser Treatment for Psoriasis and Other Selected Skin Conditions (CPB 0577, reviewed 2026-07-15)
Aetna considers excimer and pulsed dye laser treatment medically necessary for persons with mild-to-moderate localized plaque psoriasis affecting 10% or less of body area who have failed to adequately respond to 3 or more months of topical treatments, including at least 3 of the listed agents. No more than 13 laser treatments per course and 3 courses per year are generally considered medically necessary, and additional courses are not considered medically necessary if the person fails to respond to an initial course, as documented by a reduction in PASI score or other objective response measurement. The policy also covers laser hair removal for recurrent pilonidal cyst, laser treatment for acne keloidalis nuchae and penile intraepithelial neoplasia, and Nd:YAG laser for hidradenitis suppurativa. Combined pulsed dye laser and UVB for localized plaque psoriasis, and excimer or pulsed dye laser for psoriasis other than plaque psoriasis, are considered experimental, investigational or unproven, as is laser treatment for the other listed skin conditions. Laser treatment for acne scarring, keratosis pilaris, pearly penile papules and rhinophyma is considered cosmetic.
Aetna · Identified Aug 17, 2026Medium impact
Mohs Micrographic Surgery (CPB 0383, reviewed 2026-05-28)
Aetna's Clinical Policy Bulletin 0383 considers Mohs micrographic surgery medically necessary for lesions in areas of important tissue preservation (ears, face, feet, hands, genitalia and perianal area), atypical fibroxanthoma, dermatofibrosarcoma protuberans, lesions 2 cm or larger or rapidly growing, lesions in high-recurrence areas, previously irradiated skin, recurrent or incompletely excised malignant lesions, squamous cell carcinomas with high risk of metastasis, superficial melanoma in situ and lentigo maligna in areas of important tissue preservation, tumors with aggressive histologic patterns, and tumors with ill-defined borders. Aetna considers Mohs surgery for all other indications experimental, investigational or unproven, including adenoid cystic carcinoma, nail unit melanoma, pilomatrix carcinoma, vulvar malignancies and deep cutaneous fungal infections. Mohs micrographic surgery requires a single physician to act as both surgeon and pathologist, and the Mohs CPT codes are inappropriate if either role is delegated to another physician who reports those services separately.
Aetna · Identified Aug 13, 2026Medium impact
Paclitaxel, Albumin-Bound (CPB 0834, reviewed 2026-05-28)
Aetna considers albumin-bound paclitaxel (Abraxane or generic albumin-bound paclitaxel) medically necessary for the cancers listed in its initial approval criteria, including Kaposi sarcoma, breast cancer, cutaneous melanoma, endometrial carcinoma, ovarian, fallopian tube and primary peritoneal cancer, biliary tract cancers, non-small cell lung cancer, pancreatic adenocarcinoma, small bowel adenocarcinoma, uveal melanoma, ampullary adenocarcinoma, cervical cancer, bladder cancer and vaginal cancer, when each cancer's stated criteria are met. All other indications are considered experimental, investigational, or unproven, including small cell lung cancer, prostate cancer, soft-tissue sarcoma and gastric cancer. Continuation of therapy is medically necessary for an approved indication when there is no evidence of unacceptable toxicity or disease progression on the current regimen.

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Laser Treatment for Psoriasis and Other Selected Skin Conditions (CPB 0577, reviewed 2026-07-15)

Mohs Micrographic Surgery (CPB 0383, reviewed 2026-05-28)

Paclitaxel, Albumin-Bound (CPB 0834, reviewed 2026-05-28)

What insurance policy changes affect code D07.1?

Which payers have updated policy for code D07.1?

How do I get notified when code D07.1 policy changes?

Why do payers change policies for code D07.1?