I45.89 Insurance Policy Changes

ICD-10 I45.89 is officially defined as "Other specified conduction disorders." code I45.89 is referenced in 6 tracked payer policy changes from Blue Cross & Blue Shield of Mississippi, Excellus BlueCross BlueShield, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code I45.89 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
Wearable Cardioverter Defibrillators
Prior authorization and Care Management approval are required for a wearable cardioverter defibrillator (WCD) used for ischemic cardiomyopathy following an acute myocardial infarction and for newly diagnosed nonischemic cardiomyopathy. Effective 2026-10-01, the Code Reference adds ICD-10 codes I42.00, I42.01, I42.09, I42.81, I42.89, I47.22, I49.81, I49.82, and I49.89 and removes ICD-9 diagnosis codes. A WCD is medically necessary as interim treatment for individuals who meet the ICD criteria but have a temporary contraindication to an ICD, such as a systemic infection, and as a bridge to left ventricular improvement or possible ICD implantation in the covered indications.
Excellus BlueCross BlueShield · Effective Jul 16, 2026Medium impact
Cardiac Event Monitors 2.01.03
External intermittent cardiac event monitors are medically appropriate for symptoms possibly related to rhythm disturbances (such as palpitations, or serious or significant syncope and near syncope), after an ablation, and after starting or stopping anti-arrhythmic drug therapy, when the specific criteria are met. Implantable loop recorders may be considered medically appropriate for specified indications, such as infrequent recurrent syncope, near syncope, or palpitations, paroxysmal atrial fibrillation, cryptogenic stroke, and post cardiac ablation, when the criteria are met, and home-based mobile cardiac outpatient telemetry is considered not medically necessary. External monitoring to measure heart rate variability or to detect ST segment changes, and intracardiac ischemia event monitors, are investigational.
Aetna · Identified Oct 2, 2026Medium impact
Cardiac Catheter Ablation (CPB 0165, reviewed 2026-08-25)
Aetna considers cardiac catheter ablation with electrophysiological studies medically necessary for listed atrial fibrillation, atrioventricular nodal reentrant tachycardia, atrial tachycardia and flutter, accessory pathway, and ventricular arrhythmia indications, each with its own clinical conditions such as symptoms, drug failure or intolerance, or a high-risk accessory pathway. Pulsed field ablation is considered an equally acceptable alternative to standard radiofrequency ablation for medically necessary indications. Ablation for all other indications is considered experimental, investigational, or unproven, and so are alcohol ablation of the vein of Marshall, the AtriCure Isolator Synergy EnCompass Clamp, cardio-neuro-ablation, intra-myocardial infusion-needle catheter ablation for ventricular tachycardia, non-invasive cardiac radio-ablation, and sinus node-sparing hybrid ablation.
Aetna · Identified Aug 15, 2026Medium impact
Cardiac Catheter Ablation (CPB 0165)
Aetna considers catheter ablation with electrophysiological studies medically necessary for atrial fibrillation, AVNRT, atrial tachycardia and atrial flutter, accessory pathways, and ventricular arrhythmias when the listed criteria are met, such as symptomatic AF when antiarrhythmic drugs have been ineffective, contraindicated, not tolerated or not preferred. Aetna considers catheter ablation for all other indications experimental, investigational or unproven. The policy also lists alcohol ablation of the vein of Marshall, the AtriCure Isolator Synergy EnCompass Clamp, cardio-neuro-ablation for carotid sinus hypersensitivity syncope, intra-myocardial infusion-needle catheter ablation for ventricular tachycardia, non-invasive cardiac radio-ablation, and sinus node-sparing hybrid ablation as experimental, investigational or unproven. Pulsed field ablation is considered an equally acceptable alternative to standard radiofrequency ablation for medically necessary indications.
Independence Blue Cross · Identified Jun 19, 2026Low impact
MA11.060h, Catheter Ablation of Cardiac Arrhythmias
Independence Blue Cross reissued Medical Policy MA11.060h on 06/10/2026 as part of their annual review process with no substantive coverage changes. CPT code 93656 narrative was revised effective 01/01/2025 due to annual CPT code updates. The policy continues to cover catheter ablation for supraventricular and ventricular arrhythmias under specified medical necessity criteria for Medicare Advantage members.
Independence Blue Cross · Identified Jun 19, 2026Low impact
MA11.060h, Catheter Ablation of Cardiac Arrhythmias
Independence Blue Cross reissued MA11.060h (now superseded by MA11.060i) as part of their annual review process on 06/10/2026. This is a routine policy reissuance with no substantive changes to coverage criteria for catheter ablation of cardiac arrhythmias. A CPT code update (93656) was processed effective 01/01/2025, but the policy itself maintains existing coverage requirements for supraventricular and ventricular arrhythmias.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code I45.89?

There are 6 tracked policy changes affecting code I45.89, including updates from Blue Cross & Blue Shield of Mississippi, Excellus BlueCross BlueShield, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code I45.89?

Payers that have issued tracked updates for code I45.89 include: Blue Cross & Blue Shield of Mississippi, Excellus BlueCross BlueShield, Aetna, Independence Blue Cross.

How do I get notified when code I45.89 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code I45.89. 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 I45.89?

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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Wearable Cardioverter Defibrillators

Cardiac Event Monitors 2.01.03

Cardiac Catheter Ablation (CPB 0165, reviewed 2026-08-25)

Cardiac Catheter Ablation (CPB 0165)

MA11.060h, Catheter Ablation of Cardiac Arrhythmias

MA11.060h, Catheter Ablation of Cardiac Arrhythmias

What insurance policy changes affect code I45.89?

Which payers have updated policy for code I45.89?

How do I get notified when code I45.89 policy changes?

Why do payers change policies for code I45.89?