What insurance policy changes affect code D67?

There are 3 tracked policy changes affecting code D67, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code D67?

Payers that have issued tracked updates for code D67 include: Aetna.

How do I get notified when code D67 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code D67. 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 D67?

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

D67 Insurance Policy Changes

ICD-10 D67 is officially defined as "Hereditary factor IX deficiency." code D67 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 D67 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Aug 15, 2026Medium impact
Fidanacogene Elaparvovec-dzkt (Beqvez) (CPB 1060, reviewed 2026-04-20)
Aetna covers fidanacogene elaparvovec-dzkt (Beqvez, HCPCS J1414) for commercial medical plans as one dose total for adults with severe or moderately severe hemophilia B who meet the policy's criteria. The drug must be prescribed by or in consultation with a hematologist, and precertification is required. Gene therapies must be given at an Aetna Institutes GCIT Designated Network unless the member's health plan has elected not to require it.
Aetna · Identified Aug 13, 2026Medium impact
Etranacogene Dezaparvovec-drlb (Hemgenix) (CPB 1023, reviewed 2026-04-17)
Aetna's Clinical Policy Bulletin 1023 covers Hemgenix (etranacogene dezaparvovec-drlb) for commercial plans as one dose total for hemophilia B in members 18 or older who meet the listed criteria. Precertification is required for all Aetna participating providers and members in applicable plan designs, and gene therapies must be given at an Aetna Institutes GCIT Network unless the member's health plan has elected not to require it. The medication must be prescribed by or in consultation with a hematologist, and it is given as a single intravenous infusion at 2 x 10^13 genome copies per kg of body weight.
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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Fidanacogene Elaparvovec-dzkt (Beqvez) (CPB 1060, reviewed 2026-04-20)

Etranacogene Dezaparvovec-drlb (Hemgenix) (CPB 1023, reviewed 2026-04-17)

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

What insurance policy changes affect code D67?

Which payers have updated policy for code D67?

How do I get notified when code D67 policy changes?

Why do payers change policies for code D67?