What insurance policy changes affect code I86.1?

There are 2 tracked policy changes affecting code I86.1, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code I86.1?

Payers that have issued tracked updates for code I86.1 include: Aetna.

How do I get notified when code I86.1 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code I86.1. 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 I86.1?

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

I86.1 Insurance Policy Changes

ICD-10 I86.1 is officially defined as "Scrotal varices." code I86.1 is referenced in 2 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 I86.1 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 18, 2026Medium impact
Varicocele: Selected Treatments (CPB 0413, reviewed 2026-06-30)
Aetna considers percutaneous embolization (by balloon or metallic coil) or ligation medically necessary for varicocele when any of these apply: adolescents with grade 2 or 3 varicoceles associated with ipsilateral testicular growth retardation, males with infertility problems who have decreased sperm motility and lower sperm concentrations, post-surgical (ligation) recurrence of varicoceles, or scrotal pain associated with varicoceles. Embolization or ligation for persons who do not meet these criteria is considered experimental, investigational, or unproven, and microsurgical varicocelectomy is considered an acceptable alternative when any of these criteria is met. Adding a sclerosant agent to coil embolization, endoluminal occlusion devices such as the ArtVentive system, endovenous laser ablation of the spermatic vein, surgical treatment for subclinical varicocele, and varicocelectomy for non-obstructive azoospermia are considered experimental, investigational, or unproven.
Aetna · Identified Aug 16, 2026Medium impact
Scrotal Ultrasonography (CPB 0532, reviewed 2026-07-29)
Aetna considers scrotal ultrasonography (CPT 76870) medically necessary for scrotal mass lesions or tumors, undescended testes in the situations the policy lists, suspected testicular torsion, hydroceles, evaluation of infertile men, acute scrotal pain or swelling, scrotal injury or trauma, and varicoceles. Aetna considers it experimental, investigational, or unproven for other indications, including the initial evaluation for infertility unless physical examination of the scrotum is difficult or inadequate or a testicular mass is suspected, and surveillance of testicular microlithiasis in the absence of additional risk factors.

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Varicocele: Selected Treatments (CPB 0413, reviewed 2026-06-30)

Scrotal Ultrasonography (CPB 0532, reviewed 2026-07-29)

What insurance policy changes affect code I86.1?

Which payers have updated policy for code I86.1?

How do I get notified when code I86.1 policy changes?

Why do payers change policies for code I86.1?