What insurance policy changes affect code D68.62?

There are 3 tracked policy changes affecting code D68.62, including updates from Aetna, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code D68.62?

Payers that have issued tracked updates for code D68.62 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code D68.62 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code D68.62. 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 D68.62?

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

D68.62 Insurance Policy Changes

ICD-10 D68.62 is officially defined as "Lupus anticoagulant syndrome." code D68.62 is referenced in 3 tracked payer policy changes from Aetna and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code D68.62 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Aug 14, 2026Medium impact
Prothrombin Time (INR) Home Testing Devices (CPB 0173, reviewed 2026-03-20)
Aetna clinical policy bulletin 0173 considers prothrombin time (INR) home testing units medically necessary durable medical equipment for patients on chronic warfarin for a mechanical heart valve, ventricular assist device, chronic atrial fibrillation, deep venous thrombosis, pulmonary embolism, venous embolism and thrombosis of deep vessels of the lower extremity, or hypercoagulable states, when the expected need for home INR testing is 6 or more months, the patient has been anticoagulated for at least 3 months before using the device, and self-testing does not occur more than once a week. Aetna considers the units experimental, investigational, or unproven for all other indications, including arterial embolism to the eye, atrial flutter, and Kawasaki disease.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Systemic Lupus Erythematosus (SLE) & Lupus Nephritis (LN)
Benlysta (belimumab) requires prior authorization for active systemic lupus erythematosus (SLE) and active lupus nephritis (LN). Lupkynis (voclosporin) and Saphnelo (anifrolumab-fnia) are considered not medically necessary because other formulary alternatives are covered by the plan for these conditions. The most recent review, dated 02/24/2026, revised the medically necessary criteria for members with active SLE without active lupus nephritis.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
State and School Employees' Health Insurance Plan - Systemic Lupus Erythematosus (SLE) & Lupus Nephritis (LN)
Benlysta (belimumab) may be considered medically necessary for members with active systemic lupus erythematosus (SLE) with or without active lupus nephritis (LN) when the listed criteria are met. Saphnelo (anifrolumab-fnia) is considered not medically necessary because other formulary alternatives are covered by the Plan for treatment of active SLE. The most recent review, dated 02/24/2026, revised the medically necessary criteria for individuals with active SLE without active lupus nephritis.

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Prothrombin Time (INR) Home Testing Devices (CPB 0173, reviewed 2026-03-20)

Systemic Lupus Erythematosus (SLE) & Lupus Nephritis (LN)

State and School Employees' Health Insurance Plan - Systemic Lupus Erythematosus (SLE) & Lupus Nephritis (LN)

What insurance policy changes affect code D68.62?

Which payers have updated policy for code D68.62?

How do I get notified when code D68.62 policy changes?

Why do payers change policies for code D68.62?