What insurance policy changes affect code I81?

There are 5 tracked policy changes affecting code I81, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code I81?

Payers that have issued tracked updates for code I81 include: Aetna.

How do I get notified when code I81 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code I81. 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 I81?

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

I81 Insurance Policy Changes

ICD-10 I81 is officially defined as "Portal vein thrombosis." code I81 is referenced in 5 tracked payer policy changes from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code I81 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Aug 19, 2026Medium impact
Homocysteine Testing (CPB 0763, reviewed 2025-11-12)
Aetna covers homocysteine testing (CPT 83090) for borderline vitamin B12 deficiency when the results will affect management, for central retinal vein occlusion in members with a history or family history of thrombosis or who are under 56 years of age without strong arteriosclerotic risk factors, for homocystinuria caused by cystathionine beta-synthase deficiency, and for idiopathic or recurrent venous thromboembolism, thrombosis under 45 years of age, or thrombosis at an unusual site. Testing for all other listed indications, including management of 5,10-methylenetetrahydrofolate reductase (MTHFR) abnormalities, cardiovascular or stroke risk assessment, dementia and depression, is considered experimental, investigational or unproven because its effectiveness for these indications has not been established. Covered ICD-10 codes include D51.0 through D51.9, D81.818, D81.819, E53.8, I81 and I82.0 through I82.91.
Aetna · Identified Aug 18, 2026Medium impact
Transjugular Intrahepatic Portosystemic Shunt (TIPSS) (CPB 0259, reviewed 2026-04-14)
Aetna considers transjugular intrahepatic portosystemic shunt (TIPSS) medically necessary for bleeding gastric, esophageal or ectopic varices, moderate Budd-Chiari syndrome that has failed to respond to anticoagulation, portal hypertensive gastropathy with recurrent bleeding despite beta-blockers, severe refractory ascites in people who are intolerant of repeated large volume paracentesis, and refractory hepatic hydrothorax, when the member meets the selection criteria in the Appendix. TIPSS is experimental, investigational, or unproven for all other indications, including initial therapy for acute variceal hemorrhage, prophylaxis of variceal hemorrhage, and hepatorenal syndrome.
Aetna · Identified Aug 18, 2026Medium impact
Magnetic Resonance Imaging of the Cardiovascular System - Cardiac MRI (CPB 0520, reviewed 2025-08-13)
Aetna considers cardiac MRI medically necessary for a defined list of cardiovascular indications, including thoracic aortic disease, pericardial disease, congenital heart disease, atrial fibrillation, coronary artery disease, cardiomyopathies, myocarditis and cardiac masses, and several of these require that an echocardiogram was inconclusive or expected to be non-diagnostic. Requests for indications not listed are subject to medical review, and when CT, radionuclide studies, ultrasound or other MRI are also performed, the physician must document the specific information the additional test is expected to provide. Aetna considers absolute quantification of myocardial blood flow, four-dimensional flow cardiac MRI, whole heart coronary MR angiography, ferumoxytol-enhanced cardiac MRI, and cardiac MRI used as a screening test to be experimental, investigational or unproven.
Aetna · Identified Aug 17, 2026Medium impact
ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP) (CPB 0780, reviewed 2026-04-27)
Aetna considers the ADAMTS13 assay medically necessary for assessing prognosis in persons with thrombotic thrombocytopenic purpura (TTP), and for distinguishing hematopoietic stem cell transplant-associated thrombotic microangiopathy (HSCT-TMA, also called transplant-associated TMA) from TTP in persons with overlapping features when the test will be used to inform treatment. Aetna considers the assay experimental, investigational, or unproven for the uses it lists because of insufficient evidence, including sepsis-associated thrombotic microangiopathy, hemolytic uremic syndrome, acute myelogenous leukemia, colorectal cancer survival, COVID-19, cerebral infarction, and ADAMTS13 mutation testing for non-cirrhotic portal hypertension.
Aetna · Identified Oct 30, 2026Low impact
Homocysteine Testing (CPB 0763, reviewed 2026-10-28)
Aetna clinical policy bulletin CPB 0763 covers homocysteine testing and was last reviewed 10/28/2026. It lists the indications Aetna considers medically necessary, including CPT 83090 and the covered ICD-10 codes listed in the bulletin, and it states that Aetna considers homocysteine testing experimental, investigational, or unproven for all other indications. The source text does not describe what changed in this review.

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Homocysteine Testing (CPB 0763, reviewed 2025-11-12)

Transjugular Intrahepatic Portosystemic Shunt (TIPSS) (CPB 0259, reviewed 2026-04-14)

Magnetic Resonance Imaging of the Cardiovascular System - Cardiac MRI (CPB 0520, reviewed 2025-08-13)

ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP) (CPB 0780, reviewed 2026-04-27)

Homocysteine Testing (CPB 0763, reviewed 2026-10-28)

What insurance policy changes affect code I81?

Which payers have updated policy for code I81?

How do I get notified when code I81 policy changes?

Why do payers change policies for code I81?