E83.01 Insurance Policy Changes

ICD-10 E83.01 is officially defined as "Wilson's disease." code E83.01 is referenced in 5 tracked payer policy changes from Blue Cross & Blue Shield of Mississippi and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code E83.01 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Blue Cross & Blue Shield of Mississippi · Effective Oct 1, 2026Medium impact
Chelation Therapy
Chelation therapy is considered medically necessary when based on blood levels and used to treat chronic iron overload due to blood transfusions or nontransfusion-dependent thalassemia, extreme conditions of metal toxicity, lead poisoning, Wilson's disease, emergency treatment of hypercalcemia, or control of ventricular arrhythmias or heart block associated with digitalis toxicity. Off-label applications, including atherosclerosis, Alzheimer disease, arthritis, multiple sclerosis, diabetes, autism, and Parkinson disease, are considered investigational. The 08/06/2026 review added Parkinson disease to the investigational list, and the 10/01/2026 update added ICD-10 codes R78.72 and Z77.013 to the code reference.
Aetna · Identified Oct 29, 2026Medium impact
Noninvasive Tests for Hepatic Fibrosis (CPB 0690, reviewed 2026-10-26)
This Aetna Clinical Policy Bulletin (CPB 0690) addresses noninvasive tests for hepatic fibrosis and lists which tests Aetna considers medically necessary and which it considers experimental, investigational, or unproven. Aetna considers transient elastography (e.g., FibroScan) medically necessary for follow-up of primary sclerosing cholangitis, monitoring of liver function in Wilson's disease, and distinguishing hepatic cirrhosis from non-cirrhosis in persons with hepatitis B, hepatitis C or other chronic liver diseases. Performing transient elastography, magnetic resonance elastography, the Enhanced Liver Fibrosis (ELF) test, or FibroTest-ActiTest/HCV-FibroSure more than twice per year is considered not medically necessary.
Aetna · Identified Oct 23, 2026Medium impact
Anterior Segment Scanning Computerized Ophthalmic Diagnostic Imaging (CPB 0749, reviewed 2026-10-21)
Aetna considers anterior segment optical coherence tomography (OCT) experimental, investigational, or unproven for all indications, including detection of glaucoma, evaluation of conjunctival hyperemia and quantification of corneal haziness, because its clinical value has not been established. Anterior segment imaging with the Pentacam, scanning laser ophthalmoscopy (SLO) and scanning laser polarimetry (SLP) is considered experimental, investigational, or unproven because of insufficient evidence of its effectiveness. CPT code 92132 is not covered for the indications listed in the policy, and Aetna members may not be eligible for Pentacam anterior segment imaging for refractive eye surgeries such as LASIK or laser eye surgery.
Aetna · Identified Aug 18, 2026Medium impact
Noninvasive Tests for Hepatic Fibrosis (CPB 0690, reviewed 2026-06-18)
Aetna's Clinical Policy Bulletin 0690 on noninvasive tests for hepatic fibrosis, reviewed 2026-06-18, states which tests it considers medically necessary and which it considers experimental, investigational or unproven. Aetna considers transient elastography (e.g., FibroScan), FibroTest-ActiTest/HCV-FibroSure, magnetic resonance elastography and the Enhanced Liver Fibrosis (ELF) test medically necessary for the indications listed, and considers baseline liver elastography medically necessary for persons with cystic fibrosis who have hepatobiliary involvement. Each of the four tests is considered not medically necessary if performed more than twice per year. Transient elastography and FibroTest-ActiTest/HCV-FibroSure are considered not medically necessary within 6 months of a liver biopsy or of each other, and magnetic resonance elastography and ELF are considered not medically necessary within 6 months of a liver biopsy or another test for liver fibrosis. ARFI, LiverMultiScan, artificial intelligence for NAFLD, NASHnext and the OWLiver Panel are listed as experimental, investigational or unproven for the uses the policy names.
Aetna · Identified Aug 14, 2026Medium impact
Evoked Potential Studies (CPB 0181, reviewed 2026-04-21)
Aetna's Clinical Policy Bulletin 0181 sets out which evoked potential studies are medically necessary and which are experimental, investigational or unproven. Somatosensory evoked potentials are medically necessary to evaluate acute anoxic encephalopathy within 3 days of the anoxic event, suspected brain death, and clinically silent brain lesions in multiple sclerosis suspects, among other listed indications. Visual evoked potentials are medically necessary to diagnose and monitor multiple sclerosis, and brainstem auditory evoked responses are medically necessary to diagnose suspected acoustic neuroma and to screen infants and children under 3 years of age for hearing loss. Cervical vestibular evoked myogenic potentials are medically necessary for vertigo from semicircular canal dehiscence syndrome after a comprehensive evaluation with inconclusive results, and for bilateral sensorineural hearing loss after cochlear implantation. Pre-operative somatosensory evoked potentials of the bilateral tibial pathways before scoliosis surgery and somatosensory evoked potentials for carpal tunnel syndrome are listed as experimental, investigational or unproven.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code E83.01?

There are 5 tracked policy changes affecting code E83.01, including updates from Blue Cross & Blue Shield of Mississippi, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code E83.01?

Payers that have issued tracked updates for code E83.01 include: Blue Cross & Blue Shield of Mississippi, Aetna.

How do I get notified when code E83.01 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code E83.01. 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 E83.01?

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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Chelation Therapy

Noninvasive Tests for Hepatic Fibrosis (CPB 0690, reviewed 2026-10-26)

Anterior Segment Scanning Computerized Ophthalmic Diagnostic Imaging (CPB 0749, reviewed 2026-10-21)

Noninvasive Tests for Hepatic Fibrosis (CPB 0690, reviewed 2026-06-18)

Evoked Potential Studies (CPB 0181, reviewed 2026-04-21)

What insurance policy changes affect code E83.01?

Which payers have updated policy for code E83.01?

How do I get notified when code E83.01 policy changes?

Why do payers change policies for code E83.01?