What insurance policy changes affect code D34?

There are 4 tracked policy changes affecting code D34, including updates from Excellus BlueCross BlueShield, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code D34?

Payers that have issued tracked updates for code D34 include: Excellus BlueCross BlueShield, Aetna.

How do I get notified when code D34 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code D34. 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 D34?

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

D34 Insurance Policy Changes

ICD-10 D34 is officially defined as "Benign neoplasm of thyroid gland." code D34 is referenced in 4 tracked payer policy changes from Excellus BlueCross BlueShield and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code D34 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Excellus BlueCross BlueShield · Effective Nov 20, 2025Medium impact
Molecular Marker Testing of the Thyroid 2.02.49
Afirma Genomic Sequencing Classifier and ThyroSeq are considered medically necessary when indeterminate cytology (Bethesda category III or IV) is present, there are no strong clinical or radiologic findings suggestive of malignancy, and surgical decision making would be affected by the results. ThyroSeq, ThyraMIR microRNA/ThyGenX, Afirma BRAF and Afirma MTC are also considered medically necessary for Bethesda category III, IV or V cytology when malignancy must be determined and the results guide surgical planning for initial resection. RosettaGX Reveal, single-gene TERT testing, Thyroid GuidePx and Afirma Xpression Atlas are considered investigational. The 11/20/25 annual review made no changes to policy intent, although the policy statements were reformatted for clarity.
Aetna · Identified Oct 10, 2026Medium impact
Radiofrequency Tumor Ablation (CPB 0492, reviewed 2026-10-05)
Aetna considers radiofrequency ablation (RFA) medically necessary for indications that include colorectal cancer liver metastases, colorectal cancer lung metastases of 5 cm or less where the primary colorectal tumor has been resected for cure (R0 resection), malignant lung masses in persons who are not candidates for surgical intervention, solitary hepatocellular carcinoma of 5 cm or less or multinodular early-stage HCC in members who are ineligible for or decline surgical resection or transplantation, renal cell carcinoma up to 4 cm in high-risk surgical candidates or in persons with renal insufficiency or a solitary kidney, and osteoid osteoma in individuals who remain symptomatic despite NSAIDs. Aetna considers RFA experimental, investigational, or unproven for combined RFA with transarterial chemoembolization for intermediate-stage hepatocellular carcinoma, combined endoluminal RFA and stenting for malignant biliary obstruction or stricture, combined RFA and vertebral cement augmentation for spinal metastases, endoscopic ultrasound-guided RFA for aldosterone-producing adenomas, and all other indications, including curative treatment of primary or metastatic malignant neoplasms in persons able to tolerate surgical resection, biliary obstructions or strictures, renal cysts, renal angiomyolipomas, Brunner's gland hyperplasia, and unresectable localized recurrent thyroid cancers without distant metastases.
Aetna · Identified Aug 15, 2026Medium impact
Radiofrequency Tumor Ablation (CPB 0492, reviewed 2026-07-29)
Aetna considers radiofrequency ablation (RFA) medically necessary for several tumor indications, including colorectal cancer liver metastases, colorectal lung metastases of 5 cm or less where the primary colorectal tumor has been resected for cure (R0 resection), and malignant lung masses in persons who are not candidates for surgical intervention. Solitary hepatocellular carcinoma of 5 cm or less is covered in members who are ineligible for or decline surgical resection or transplantation, and renal cell carcinoma up to 4 cm is covered in high-risk surgical candidates, persons with renal insufficiency, or persons with a solitary kidney. The policy lists curative RFA of malignant neoplasms in persons who are able to tolerate surgical resection, combined RFA with trans-arterial chemoembolization for intermediate-stage hepatocellular carcinoma, combined endoluminal RFA and stenting for malignant biliary obstruction or stricture, and combined RFA with vertebral cement augmentation for spinal metastases as experimental, investigational, or unproven.
Aetna · Identified Aug 14, 2026Medium impact
Ethanol Injection for Thyroid Lesions and Other Selected Indications (CPB 0395, reviewed 2026-07-06)
Ethanol sclerotherapy of thyroglossal duct cysts is medically necessary only when a monocystic lesion is present, cystographic studies show no extravasation, and cytology shows the lesion is benign. Ethanol sclerotherapy is also medically necessary for symptomatic venous malformations of the head and neck, absolute ethanol injection is medically necessary for overt upper gastrointestinal bleeding, and ethanol ablation is medically necessary for benign thyroid nodules. Ethanol sclerotherapy for endometrioma, intradiscal radiopaque gelified ethanol injection for lumbar disc herniation, percutaneous ethanol injection for thyroid cancer, and ultrasound-guided ethanol sclerotherapy for Warthin's tumor are considered experimental, investigational, or unproven.

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Molecular Marker Testing of the Thyroid 2.02.49

Radiofrequency Tumor Ablation (CPB 0492, reviewed 2026-10-05)

Radiofrequency Tumor Ablation (CPB 0492, reviewed 2026-07-29)

Ethanol Injection for Thyroid Lesions and Other Selected Indications (CPB 0395, reviewed 2026-07-06)

What insurance policy changes affect code D34?

Which payers have updated policy for code D34?

How do I get notified when code D34 policy changes?

Why do payers change policies for code D34?