G24.3 Insurance Policy Changes

ICD-10 G24.3 is officially defined as "Spasmodic torticollis." code G24.3 is referenced in 6 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 G24.3 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Aug 18, 2026Medium impact
Thalamotomy (CPB 0153, reviewed 2026-03-30)
Aetna considers unilateral thalamotomy medically necessary for abolishing tremor and rigidity in members with dystonia, Parkinson's disease, spasmodic torticollis, or tremor who meet all listed selection criteria, including a positive initial response to medication that later became refractory, screening by a neurologist with movement disorders expertise, and severe, incapacitating tremor where medical therapy has failed. Focused ultrasound thalamotomy is covered for severe essential tremor inadequately responsive to medical therapy, gamma knife thalamotomy is covered for severe essential tremor or for refractory disabling tremor and rigidity from Parkinson's disease, and thalamotomy is covered as a last resort for malignant pain when all listed criteria are met. Bilateral thalamotomy, focused ultrasound thalamotomy for tremor syndromes other than essential tremor, and thalamotomy for non-malignant pain are considered experimental, investigational, or unproven.
Aetna · Identified Aug 16, 2026Medium impact
Selective Peripheral Denervation (Bertrand Procedure) (CPB 0401, reviewed 2026-07-06)
Aetna considers selective peripheral denervation (Bertrand procedure) medically necessary for severe spasmodic torticollis (cervical dystonia) when current symptoms are disabling and either of the following is met: the member tried 3 months of oral anticholinergics or benzodiazepines (or had adverse side effects from them), or the member tried 3 months of botulinum toxin type A or B injection or developed resistance to botulinum toxin therapy. When these criteria are not met, the procedure is considered experimental, investigational, or unproven. Combined selective peripheral denervation and deep brain stimulation for spasmodic torticollis, and selective peripheral neurectomy for upper limb spasticity, are also considered experimental, investigational, or unproven.
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.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Deep Brain Stimulation
Unilateral or bilateral deep brain stimulation of the thalamus may be considered medically necessary for disabling, medically unresponsive tremor due to essential tremor or Parkinson disease, and bilateral thalamic stimulation for tremor in both upper limbs. Unilateral or bilateral stimulation of the globus pallidus or subthalamic nucleus may be considered medically necessary for Parkinson disease and for chronic, intractable primary dystonia in individuals older than 7 years. Adaptive deep brain stimulation for Parkinson disease, deep brain stimulation for other movement disorders, cluster headaches, and the other psychiatric or neurologic disorders listed in the policy are considered investigational. A 06/05/2025 update added that adaptive deep brain stimulation for Parkinson disease is considered investigational, and a 09/16/2026 update changed the description of deep brain stimulation systems and removed ICD-9 procedure and diagnosis codes from the code reference, with the policy statements unchanged.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
State and School Employees' Health Insurance Plan - Botulinum Toxin
Botox (onabotulinumtoxinA) is the only covered botulinum toxin preparation for non-cosmetic indications under this policy. Dysport, Myobloc and Xeomin are considered not medically necessary because a formulary alternative is available. Botox may be considered medically necessary for overactive bladder, detrusor overactivity associated with a neurologic condition, chronic migraine prophylaxis, spasticity, cervical dystonia, primary axillary hyperhidrosis, blepharospasm, strabismus and spasmodic dysphonia when all criteria for the indication are met. Each indication has a 12-month length of approval and a maximum dose per 12 weeks. Revised criteria for detrusor overactivity, migraine prophylaxis and blepharospasm were approved by the Pharmacy and Therapeutics Committee on 05/26/2026.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Botulinum Toxin
Botox (onabotulinumtoxinA) is the only botulinum toxin the policy covers for non-cosmetic indications, and prior authorization is required. Dysport, Myobloc and Xeomin are currently considered not medically necessary because a formulary alternative is available. The policy was reviewed and approved on 05/26/2026, and that revision states that the use of samples will not be considered current or stable therapy and revises the maximum cumulative Botox dose for individuals treated for one or more indications.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code G24.3?

There are 6 tracked policy changes affecting code G24.3, 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 G24.3?

Payers that have issued tracked updates for code G24.3 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code G24.3 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code G24.3. 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 G24.3?

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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Thalamotomy (CPB 0153, reviewed 2026-03-30)

Selective Peripheral Denervation (Bertrand Procedure) (CPB 0401, reviewed 2026-07-06)

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

Deep Brain Stimulation

State and School Employees' Health Insurance Plan - Botulinum Toxin

Botulinum Toxin

What insurance policy changes affect code G24.3?

Which payers have updated policy for code G24.3?

How do I get notified when code G24.3 policy changes?

Why do payers change policies for code G24.3?