D44.3 Insurance Policy Changes

ICD-10 D44.3 is officially defined as "Neoplasm of uncertain behavior of pituitary gland." code D44.3 is referenced in 3 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 D44.3 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 16, 2025Medium impact
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy 6.01.12
Excellus BlueCross BlueShield stereotactic radiosurgery and stereotactic body radiation therapy medical policy 6.01.12 has a current effective date of November 16, 2025. Its October 16, 2025 annual review removed life expectancy criteria from the policy criteria. SRS is considered medically appropriate for specified benign, brain and neurologic indications, SBRT is considered medically appropriate for specified extracranial cancers and oligometastatic disease, and SBRT is considered not medically necessary for indications including extrahepatic bile duct cancer, gallbladder cancer and chronic pain.
Aetna · Identified Aug 17, 2026Medium impact
Myringotomy and Tympanostomy Tube (CPB 0418, reviewed 2026-06-30)
Aetna considers myringotomy and tympanostomy tube insertion medically necessary for cholesteatoma, chronic retraction of the tympanic membrane or pars flaccida, complications of otitis media such as meningitis, facial nerve paralysis, coalescent mastoiditis or brain abscess, and severe otalgia in acute otitis media. Tympanostomy tube insertion is medically necessary for otitis media with effusion lasting 3 months or longer with bilateral hearing impairment of 20 dB or worse in both ears, and for recurrent acute otitis media with more than 3 episodes in 6 months or more than 4 episodes in 12 months. Tympanostomy tube insertion is not medically necessary for a single episode of otitis media with effusion lasting less than 3 months, or for recurrent acute otitis media in children who have no middle ear effusion in either ear at the time of assessment for tube candidacy. Balloon dilation of the Eustachian tube is medically necessary for individuals 8 to 17 years of age, and for adults with chronic Eustachian tube dysfunction, when the listed criteria are met. Shim placement in the Eustachian tube is medically necessary for a patulous Eustachian tube. OtoScan laser-assisted myringotomy is considered as effective as traditional myringotomy, and the same selection criteria apply to both. Myringotomy and tympanostomy tube insertion for all other indications, soft-tissue fillers for a patulous Eustachian tube, phosphorylcholine-coated and vancomycin-coated tympanostomy tubes, the EarPopper device, balloon dilation of the Eustachian tube after an initially successful or unsuccessful balloon dilation, with tympanoplasty or other middle ear surgery, or for chronic ear disease, the Tubes Under Local Anesthesia (Tula) System, and the Hummingbird Tympanostomy Tube System are considered experimental, investigational or unproven.
Aetna · Identified Aug 14, 2026Medium impact
Quantitative Pupillometry/Pupillography (CPB 0879, reviewed 2025-12-29)
Aetna considers quantitative pupillometry and pupillography experimental, investigational, or unproven for all indications, including the following: intracranial pressure monitoring, pain assessment, early concussion assessment, Parkinson disease, Alzheimer's disease, heart failure, depression, prediction of outcome after cardiac arrest, and glaucoma, because its effectiveness has not been established. Chromatic pupillography is considered experimental, investigational, or unproven for detecting glaucoma, Leber congenital amaurosis, optic nerve diseases, and retinitis pigmentosa, and for evaluating Gaucher disease and hemianopia. CPT 95919 (quantitative pupillometry with physician or other qualified health care professional interpretation and report) is listed as not covered for the indications in this policy.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code D44.3?

There are 3 tracked policy changes affecting code D44.3, 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 D44.3?

Payers that have issued tracked updates for code D44.3 include: Excellus BlueCross BlueShield, Aetna.

How do I get notified when code D44.3 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code D44.3. 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 D44.3?

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.

All billing codes J3590 C9399 J3490 99215 99213 99202

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Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy 6.01.12

Myringotomy and Tympanostomy Tube (CPB 0418, reviewed 2026-06-30)

Quantitative Pupillometry/Pupillography (CPB 0879, reviewed 2025-12-29)

What insurance policy changes affect code D44.3?

Which payers have updated policy for code D44.3?

How do I get notified when code D44.3 policy changes?

Why do payers change policies for code D44.3?