What insurance policy changes affect code E66.811?

There are 3 tracked policy changes affecting code E66.811, 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 E66.811?

Payers that have issued tracked updates for code E66.811 include: Excellus BlueCross BlueShield, Aetna.

How do I get notified when code E66.811 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code E66.811. 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 E66.811?

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

E66.811 Insurance Policy Changes

ICD-10 E66.811 is officially defined as "Obesity, class 1." code E66.811 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 E66.811 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 May 21, 2026Medium impact
Bariatric and Metabolic Surgery 7.01.29
Excellus BlueCross BlueShield policy 7.01.29 has a current effective date of May 21, 2026. A code edit dated 06/16/26 added CPT 43889, transoral endoscopic sleeve gastroplasty (ESG), back to the policy after its erroneous removal, and the code is listed as (E/I) experimental/investigational with an effective date of 01/01/26. The policy covers surgical treatment of obesity by Roux-en-Y gastric bypass, biliopancreatic diversion with duodenal switch, SADI-S, laparoscopic adjustable gastric banding, and sleeve gastrectomy when all listed BMI, documentation and clearance criteria are met.
Aetna · Identified Oct 7, 2026Medium impact
Brain Natriuretic Peptide Testing (CPB 0618, reviewed 2026-09-29)
Aetna considers measurement of plasma brain natriuretic peptide (BNP) medically necessary to differentiate dyspnea due to heart failure from pulmonary disease, to determine prognosis or severity in chronic heart failure, to screen for heart failure annually in adults with diabetes mellitus, to measure upon hospital admission and before discharge in acutely decompensated heart failure, for preoperative cardiac risk assessment before elevated-risk noncardiac surgery in members with known cardiovascular disease, age 65 or older, or age 45 or older with cardiovascular symptoms, and as an adjunct test for risk stratification of Stage C aortic stenosis. Serial BNP and NT-proBNP measurements and the other uses listed in the policy, such as diagnosing Kawasaki disease, are considered experimental, investigational, or unproven. CPT 83880 is covered when the selection criteria are met, except as a cardiovascular biomarker in healthy normal subjects and for identifying stress-induced myocardial ischemia.
Aetna · Identified Aug 18, 2026Medium impact
Nutritional Counseling (CPB 0049, reviewed 2026-03-10)
Aetna considers nutritional counseling a medically necessary preventive service for children and adults who are obese, and for adults who are overweight and have hypertension, dyslipidemia, impaired fasting glucose, or metabolic syndrome, when a provider recognized under the plan furnishes it. Aetna also considers counseling medically necessary for other chronic conditions where dietary adjustment has a therapeutic role, including diabetes, eating disorders, gastrointestinal disorders, hypertension, kidney disease, and seizures (ketogenic diet). Aetna considers counseling of unproven value for asthma, attention-deficit hyperactivity disorder, and chronic fatigue syndrome, and considers the NutrEval test experimental, investigational, or unproven.

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Bariatric and Metabolic Surgery 7.01.29

Brain Natriuretic Peptide Testing (CPB 0618, reviewed 2026-09-29)

Nutritional Counseling (CPB 0049, reviewed 2026-03-10)

What insurance policy changes affect code E66.811?

Which payers have updated policy for code E66.811?

How do I get notified when code E66.811 policy changes?

Why do payers change policies for code E66.811?