What insurance policy changes affect code I06.9?

There are 2 tracked policy changes affecting code I06.9, 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 I06.9?

Payers that have issued tracked updates for code I06.9 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code I06.9 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code I06.9. 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 I06.9?

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

I06.9 Insurance Policy Changes

ICD-10 I06.9 is officially defined as "Rheumatic aortic valve disease, unspecified." code I06.9 is referenced in 2 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 I06.9 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Only a small number of policies match this filter. Check back as coverage expands.

Aetna · Identified Aug 13, 2026Medium impact
Percutaneous Transluminal Septal Myocardial Ablation (PTSMA) (CPB 0558, reviewed 2026-02-19)
Aetna Clinical Policy Bulletin 0558 considers percutaneous transluminal septal myocardial ablation (PTSMA) by alcohol-induced septal branch occlusion medically necessary for hypertrophic obstructive cardiomyopathy (HOCM) in adults 21 years of age and older when all listed criteria are met, including severe symptoms despite optimal drug therapy, NYHA class III or IV, a peak LVOT gradient of at least 50 mm Hg, and suitable coronary anatomy with an identifiable septal perforator artery. Aetna also considers PTSMA medically necessary for carefully selected members 5 to 20 years of age with HOCM when the pediatric criteria are met, and it considers PTSMA for all other indications, SESAME, and ultrasound-guided PTSMA experimental, investigational, or unproven.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Transcatheter Aortic Valve Implantation for Aortic Stenosis
Transcatheter aortic valve replacement with an FDA-approved transcatheter heart valve system may be considered medically necessary for individuals with native valve aortic stenosis who have severe aortic stenosis with a calcified aortic valve, New York Heart Association Class II, III or IV heart failure symptoms, and no unicuspid or bicuspid aortic valves. Valve-in-valve replacement of a failed surgical bioprosthetic aortic valve may be considered medically necessary when the individual meets the policy's surgical risk criteria documented by at least 2 cardiovascular specialists, and use of a cerebral embolic protection device (e.g., Sentinel) during these procedures is considered investigational. The 08/13/2025 update changed the policy description regarding devices, and the policy statements are unchanged.

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Percutaneous Transluminal Septal Myocardial Ablation (PTSMA) (CPB 0558, reviewed 2026-02-19)

Transcatheter Aortic Valve Implantation for Aortic Stenosis

What insurance policy changes affect code I06.9?

Which payers have updated policy for code I06.9?

How do I get notified when code I06.9 policy changes?

Why do payers change policies for code I06.9?