K11.7 Insurance Policy Changes

ICD-10 K11.7 is officially defined as "Disturbances of salivary secretion." code K11.7 is referenced in 5 tracked payer policy changes from Aetna and Independence Blue Cross. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code K11.7 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
Xerostomia: Selected Treatments (CPB 0302, reviewed 2026-04-14)
Aetna considers electrical stimulation devices, including the Salitron System and the Saliwell Crown, experimental, investigational, or unproven for the prevention or treatment of xerostomia (dry mouth) or for any other indication. The bulletin also lists acupuncture, acupuncture-like transcutaneous electrical nerve stimulation (ALTENS), adipose tissue-derived mesenchymal stem cell therapy, fat grafting to salivary glands, hyperbaric oxygen, low-level laser or light therapy, transcutaneous electrical nerve stimulation (TENS), and Venalot Depot as experimental, investigational, or unproven for treating xerostomia. Several CPT and HCPCS codes are listed as not covered for the indications in the bulletin.
Aetna · Identified Aug 18, 2026Medium impact
Treatments to Control Drooling (Sialorrhea) (CPB 0265, reviewed 2026-04-16)
Aetna considers surgical correction of refractory excessive drooling medically necessary when the drooling is associated with significant morbidity such as skin maceration, poor oral hygiene or dehydration, and the member has failed to adequately respond to appropriate physical therapy and drug therapy. The medically necessary procedures are excision of the submandibular gland with or without parotid duct ligation, four-duct ligation, bilateral parotid duct diversion (Wilke type procedure) in the listed variants, relocation of the submandibular ducts with or without removal of the sublingual glands, and tympanic neurectomy or chorda tympani neurectomy. Transoral submandibular ganglion neurectomy, alone or with sublingual gland excision, kinesio taping and sclerotherapy are considered experimental, investigational, or unproven, and surgical correction of drooling is considered cosmetic when the criteria are not met.
Aetna · Identified Aug 14, 2026Medium impact
Eagle's and Ernest Syndrome (CPB 0400, reviewed 2026-06-30)
Aetna's Clinical Policy Bulletin 0400 considers styloidectomy medically necessary for Eagle's syndrome only when specific criteria are met, with separate criteria for the non-vascular form and the vascular form linked to carotid artery dissection. Radiofrequency thermoneurolysis is considered experimental, investigational or unproven for Eagle's and Ernest syndromes, and styloidectomy for jugular vein stenosis, for carotid stenosis without dissection, and for other listed indications such as tinnitus, headache and neck pain is also considered experimental, investigational or unproven.
Independence Blue Cross · Effective Oct 1, 2025Low impact
MA11.080c, Mentoplasty or Genioplasty
Independence Blue Cross reissued MA11.080c (Mentoplasty or Genioplasty) with ICD-10 code description updates only—no coverage policy changes. Six craniosynostosis codes (Q75.001, Q75.002, Q75.009, Q75.021, Q75.022, Q75.029) have revised descriptions for clarity. Medical necessity criteria and covered conditions remain unchanged.
Independence Blue Cross · Effective Oct 1, 2025Low impact
11.14.01i, Mentoplasty or Genioplasty
Independence Blue Cross reissued Policy 11.14.01i with ICD-10 code description updates (effective 10/01/2025) and conducted an annual review reissuance (effective 03/04/2026). The policy coverage criteria for mentoplasty/genioplasty remain unchanged—procedures are covered when medically necessary for specific conditions (congenital deformities, trauma, OSA, etc.) but excluded when performed for cosmetic purposes. Seven ICD-10 codes were updated with clarified terminology (e.g., 'craniosynostosis unspecified' to 'craniosynostosis, unspecified type'), but these are formatting updates only with no impact on coverage determinations.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code K11.7?

There are 5 tracked policy changes affecting code K11.7, including updates from Aetna, Independence Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code K11.7?

Payers that have issued tracked updates for code K11.7 include: Aetna, Independence Blue Cross.

How do I get notified when code K11.7 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code K11.7. 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 K11.7?

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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Xerostomia: Selected Treatments (CPB 0302, reviewed 2026-04-14)

Treatments to Control Drooling (Sialorrhea) (CPB 0265, reviewed 2026-04-16)

Eagle's and Ernest Syndrome (CPB 0400, reviewed 2026-06-30)

MA11.080c, Mentoplasty or Genioplasty

11.14.01i, Mentoplasty or Genioplasty

What insurance policy changes affect code K11.7?

Which payers have updated policy for code K11.7?

How do I get notified when code K11.7 policy changes?

Why do payers change policies for code K11.7?