What insurance policy changes affect code D66?

There are 2 tracked policy changes affecting code D66, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code D66?

Payers that have issued tracked updates for code D66 include: Aetna.

How do I get notified when code D66 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code D66. 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 D66?

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

D66 Insurance Policy Changes

ICD-10 D66 is officially defined as "Hereditary factor VIII deficiency." code D66 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 D66 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 19, 2026Medium impact
Valoctocogene Roxaparvovec-rvox (Roctavian) (CPB 1037, reviewed 2026-04-20)
Aetna covers one dose of valoctocogene roxaparvovec-rvox (Roctavian) for severe hemophilia A when the member meets its initial approval criteria. These include age 18 or older, factor VIII activity of 1 IU/dL or less, no pre-existing AAV5 antibodies confirmed by an FDA-approved test, and at least 150 exposure days of prophylactic factor VIII use. The drug must be prescribed by or in consultation with a hematologist, and Aetna considers all other indications experimental, investigational or unproven.
Aetna · Identified Aug 13, 2026Medium impact
Clotting Factors (CPB 0131, reviewed 2026-04-23)
Aetna's clotting factor policy applies to commercial medical plans, and the Medicare criteria are set out separately in the Medicare Part B Criteria. Precertification of clotting factors is required of all Aetna participating providers and members in applicable plan designs, and it is requested through Aetna's Special Case Precertification Unit at (855) 888-9046. Clotting factor products must be prescribed by or in consultation with a hematologist, and Aetna considers all other indications experimental, investigational, or unproven.

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Valoctocogene Roxaparvovec-rvox (Roctavian) (CPB 1037, reviewed 2026-04-20)

Clotting Factors (CPB 0131, reviewed 2026-04-23)

What insurance policy changes affect code D66?

Which payers have updated policy for code D66?

How do I get notified when code D66 policy changes?

Why do payers change policies for code D66?