E08.42 Insurance Policy Changes

ICD-10 E08.42 is officially defined as "Diabetes mellitus due to underlying condition with diabetic polyneuropathy." code E08.42 is referenced in 5 tracked payer policy changes from Independence Blue Cross and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code E08.42 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Independence Blue Cross · Effective Mar 4, 2026Medium impact
MA07.027h, Autonomic Nervous System Testing
Independence Blue Cross reissued MA07.027h on 03/04/2026 to reaffirm the Company's position on autonomic nervous system (ANS) testing. The policy clarifies that ANS testing using noninvasive, portable, automated devices remains experimental/investigational, while formal laboratory-based diagnostic testing is covered only for specific clinical indications. The BILLING REQUIREMENT header has been removed from the policy structure. Billing teams must ensure claims for ANS testing (CPT 95921, 95922, 95923) meet documented medical necessity criteria and are not submitted for screening purposes.
Aetna · Identified Aug 12, 2026Medium impact
Orthopedic Casts, Braces and Splints (CPB 0009, reviewed 2026-01-20)
Aetna considers orthoses, casts and splints medically necessary when they treat disease or injury for the listed indications, including lumbar and thoracic-lumbar-sacral braces that facilitate healing after a spine injury or spinal surgery, post-operative back braces applied within 6 weeks after spinal surgery, cervical braces for neck injury and torticollis, Unna boots for non-fracture care, air casts for fractures or other injuries, and prefabricated volar wrist braces for carpal tunnel syndrome. Prophylactic lumbar supports are considered experimental, investigational, or unproven, and elastic support garments and protective body socks do not meet Aetna's definition of covered durable medical equipment. Custom-fitted back braces are medically necessary where there is a failure, contraindication or intolerance to an unmodified, prefabricated back brace, and medical record documentation must support all coverage criteria because supplier-prepared statements and practitioner attestations alone are not sufficient.
Aetna · Identified Aug 12, 2026Medium impact
Autonomic Testing / Sudomotor Tests (CPB 0485, reviewed 2026-08-11)
Aetna considers autonomic testing, including quantitative sudomotor axon reflex test (QSART), silastic sweat imprint, and thermoregulatory sweat test (TST), medically necessary as a diagnostic tool for amyloid neuropathy, autoimmune autonomic ganglionopathy, diabetic autonomic neuropathy, distal small fiber neuropathy, idiopathic neuropathy, long-COVID syndrome with suspected autonomic disorder, multiple system atrophy, orthostatic hypotension, Parkinson disease, postural tachycardia syndrome, pure autonomic failure, recurrent unexplained syncope, reflex sympathetic dystrophy or causalgia, and Sjogren's syndrome. Aetna considers autonomic testing experimental, investigational, or unproven for other indications, including chronic fatigue syndrome/myalgic encephalomyelitis, concussion, predicting foot ulcers, Raynaud phenomenon, traumatic brachial plexus injury, and traumatic brain injury. Sympathetic skin response testing, EZSCAN, SudoScan, QDIRT, QPART, VitalScan Systems, and automated devices that generate their own software interpretation are considered experimental, investigational, or unproven for the uses listed in the policy.
Independence Blue Cross · Effective Jun 16, 2025Low impact
MA07.027h, Autonomic Nervous System Testing
Independence Blue Cross reissued MA07.027h (Autonomic Nervous System Testing) on 03/04/2026 to reaffirm the Company's continuing position on ANS testing coverage. The primary change was removal of the BILLING REQUIREMENT header; coverage criteria remain unchanged, with testing covered only when meeting specific diagnostic or clinical decision-making indications, and explicitly not covered for screening purposes.
Independence Blue Cross · Effective Jun 16, 2025Low impact
07.03.23h, Autonomic Nervous System Testing
Independence Blue Cross reissued its Autonomic Nervous System (ANS) Testing policy effective 06/16/2025, maintaining coverage for medically necessary diagnostic and clinical decision-making ANS testing while continuing to exclude noninvasive portable automated devices (ANSAR ANX 3.0, SUDOSCAN, ESC) as experimental/investigational. The BILLING REQUIREMENT header was removed from the policy, but coverage criteria and covered CPT codes (95921, 95922, 95923) remain unchanged.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code E08.42?

There are 5 tracked policy changes affecting code E08.42, including updates from Independence Blue Cross, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code E08.42?

Payers that have issued tracked updates for code E08.42 include: Independence Blue Cross, Aetna.

How do I get notified when code E08.42 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code E08.42. 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 E08.42?

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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MA07.027h, Autonomic Nervous System Testing

Orthopedic Casts, Braces and Splints (CPB 0009, reviewed 2026-01-20)

Autonomic Testing / Sudomotor Tests (CPB 0485, reviewed 2026-08-11)

MA07.027h, Autonomic Nervous System Testing

07.03.23h, Autonomic Nervous System Testing

What insurance policy changes affect code E08.42?

Which payers have updated policy for code E08.42?

How do I get notified when code E08.42 policy changes?

Why do payers change policies for code E08.42?