What insurance policy changes affect code D18.1?

There are 2 tracked policy changes affecting code D18.1, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code D18.1?

Payers that have issued tracked updates for code D18.1 include: Aetna.

How do I get notified when code D18.1 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code D18.1. 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 D18.1?

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

D18.1 Insurance Policy Changes

ICD-10 D18.1 is officially defined as "Lymphangioma, any site." code D18.1 is referenced in 2 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 D18.1 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Only a small number of policies match this filter. Check back as coverage expands.

Aetna · Identified Aug 16, 2026Medium impact
Lymphangioma and Infantile Hemangioma (CPB 0817, reviewed 2025-12-03)
Treatment of hemangiomas of infancy is medically necessary when the lesion compromises vital structures such as the nose, eyes, ears, lips or larynx, is associated with Kasabach-Merritt Syndrome, is symptomatic, or results in a documented functional impairment, using cryosurgery or cryotherapy, embolization, intralesional steroids, laser therapy, radiotherapy, sclerosing therapy or surgical excision alone or in combination. Oral propranolol for proliferating infantile hemangioma requiring systemic therapy (corticosteroids) is medically necessary, and inpatient initiation is medically necessary for infants 8 weeks or younger (corrected age), infants without adequate social support, and infants with co-morbid cardiovascular, airway or blood glucose conditions. Atenolol, pigment epithelium-derived factor, topical timolol, C19MC microRNA and serum VEGF biomarker measurements, and sirolimus for diffuse intestinal infantile hemangioma are considered experimental, investigational or unproven.
Aetna · Identified Aug 14, 2026Medium impact
Pulsed Dye Laser Treatment (CPB 0559, reviewed 2025-08-22)
Pulsed dye laser treatment is medically necessary for actinic keratoses that failed to adequately respond to imiquimod, 5-FU, or cryosurgery, for capillary malformation with overgrowth or vascular malformation, for genital warts when home therapy with podophyllotoxin or imiquimod has failed, for granuloma faciale, for infantile hemangiomas, and for port wine stains and other hemangiomas on the face and neck. It is also medically necessary for keloids or hypertrophic scars from an injury or surgical procedure that cause significant pain requiring chronic analgesic medication or significant functional impairment, for multiple superficially located glomangiomas in the face and neck where surgical excision is not practical, for pyogenic granuloma in the face and neck, for symptomatic angiolymphoid hyperplasia that has failed medical therapy, and for verrucae after at least two conventional therapies have failed. Pulsed dye laser is considered experimental, investigational, or unproven for other conditions, including active acne, onychomycosis, hidradenitis suppurativa, molluscum contagiosum, and morphea, and cosmetic for conditions including rosacea, facial redness, solar lentigines, and striae distensae.

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Lymphangioma and Infantile Hemangioma (CPB 0817, reviewed 2025-12-03)

Pulsed Dye Laser Treatment (CPB 0559, reviewed 2025-08-22)

What insurance policy changes affect code D18.1?

Which payers have updated policy for code D18.1?

How do I get notified when code D18.1 policy changes?

Why do payers change policies for code D18.1?