I67.89 Insurance Policy Changes

ICD-10 I67.89 is officially defined as "Other cerebrovascular disease." code I67.89 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 I67.89 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 15, 2026Medium impact
Magnetic Resonance Spectroscopy (MRS) 6.01.03
Effective May 15, 2026, Excellus BCBS policy 6.01.03 considers magnetic resonance spectroscopy (MRS) medically appropriate when conventional MRI or CT provides limited information and one of six indications applies, including distinguishing recurrent brain tumor from radiation necrosis as an alternative to PET, evidence or suspicion of primary or secondary neoplasm, grading of primary glial neoplasm, evidence or suspicion of brain infection, and seizures, especially temporal lobe epilepsy. The 01/22/26 update added a statement that MRS for the spine is not medically necessary, and MRS is not medically necessary for all spine uses. MRS is investigational for all other indications.
Aetna · Identified Aug 15, 2026Medium impact
Cerebral Perfusion Studies (CPB 0663, reviewed 2026-04-14)
Aetna considers CT perfusion studies of the brain medically necessary for evaluating acute stroke (less than 24 hours), including hemorrhagic stroke, subdural hemorrhage and transient ischemic attacks, for following up cerebral ischemia or infarction, for planning therapy for cervical or intracranial arterial occlusive disease, for identifying cerebral hyperperfusion after revascularization, and for evaluating the vascular status of solid tumors when MRI is degraded by susceptibility artifact. Aetna considers MRI perfusion studies medically necessary for diagnosing and following mass lesions such as glioma, for assessing acute stroke penumbra, and for assessing the hemodynamic significance of cervical or intracranial vascular stenosis and the efficacy of revascularization. Aetna considers CT perfusion experimental, investigational or unproven for indications including confirmation of brain death, differentiation of lung cancer from benign lesions, evaluation of head trauma and evaluation of cerebral vasospasm, and considers MRI perfusion unproven for indications including evaluation of traumatic brain injury, evaluation of persistent pain and prognostication of obstructive sleep apnea.
Aetna · Identified Aug 14, 2026Medium impact
Near-Infrared (NIR) Spectroscopy (CPB 0796, reviewed 2025-11-19)
Aetna's Clinical Policy Bulletin 0796 considers near-infrared (NIR) spectroscopy experimental, investigational or unproven for a long list of indications, including monitoring cerebral perfusion during cardiac and non-cardiac surgery, use in the intensive care and neonatal intensive care settings, evaluating dementia, diagnosing mood disorders and schizophrenia, assessing pain, and treatment of restless legs syndrome. The policy also considers NIR intravascular ultrasound coronary imaging (for example the InfraReDx LipiScan IVUS Imaging System) experimental for all indications. It considers NIR spectroscopy using spatial frequency domain imaging (for example the Ox-Imager CS device) unproven for identifying and evaluating vascular tissue compromise and for all other indications, because there is a lack of clinical studies demonstrating that this approach improves clinical outcomes. Non-contact NIR spectroscopy (for example SnapshotNIR) is considered unproven for intra-operative wound assessment and all other indications because of insufficient evidence of its effectiveness.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code I67.89?

There are 3 tracked policy changes affecting code I67.89, 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 I67.89?

Payers that have issued tracked updates for code I67.89 include: Excellus BlueCross BlueShield, Aetna.

How do I get notified when code I67.89 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code I67.89. 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 I67.89?

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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Magnetic Resonance Spectroscopy (MRS) 6.01.03

Cerebral Perfusion Studies (CPB 0663, reviewed 2026-04-14)

Near-Infrared (NIR) Spectroscopy (CPB 0796, reviewed 2025-11-19)

What insurance policy changes affect code I67.89?

Which payers have updated policy for code I67.89?

How do I get notified when code I67.89 policy changes?

Why do payers change policies for code I67.89?