What insurance policy changes affect code L89.301?

There are 2 tracked policy changes affecting code L89.301, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code L89.301?

Payers that have issued tracked updates for code L89.301 include: Aetna.

How do I get notified when code L89.301 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code L89.301. 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 L89.301?

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

L89.301 Insurance Policy Changes

ICD-10 L89.301 is officially defined as "Pressure ulcer of unspecified buttock, stage 1." code L89.301 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 L89.301 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 13, 2026Medium impact
Pressure Reducing Support Surfaces (CPB 0430, reviewed 2026-07-10)
Aetna's Clinical Policy Bulletin 0430 covers pressure-reducing support surfaces as durable medical equipment and sets separate criteria for group 1 mattresses and overlays, group 2 alternating pressure and low air loss surfaces, and group 3 air-fluidized beds. Group 2 surfaces are medically necessary when the member meets criteria such as having multiple stage II pressure ulcers on the trunk or pelvis after a comprehensive ulcer treatment program, having large or multiple stage III or IV ulcers on the trunk or pelvis, or having had a recent myocutaneous flap or skin graft. A support surface that does not prevent bottoming out is considered not medically necessary, and ordinary consumer-grade air mattresses are not covered because they do not meet Aetna's contractual definition of durable medical equipment.
Aetna · Identified Aug 15, 2026Low impact
Extracorporeal Shock-Wave Therapy for Musculoskeletal Indications and Soft Tissue Injuries (CPB 0649, reviewed 2025-10-02)
This is Aetna Clinical Policy Bulletin 0649, reviewed October 2, 2025 and first found by PolicyChanges in August 2026, so it is historical material and the current version should be confirmed before acting. Aetna covers extracorporeal shock-wave therapy only for calcific tendinopathy of the shoulder with a calcium deposit of at least 1 cm lasting 6 months or more after conservative care has failed, and lists dozens of other musculoskeletal, wound and medical uses as experimental, investigational or unproven.

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Pressure Reducing Support Surfaces (CPB 0430, reviewed 2026-07-10)

Extracorporeal Shock-Wave Therapy for Musculoskeletal Indications and Soft Tissue Injuries (CPB 0649, reviewed 2025-10-02)

What insurance policy changes affect code L89.301?

Which payers have updated policy for code L89.301?

How do I get notified when code L89.301 policy changes?

Why do payers change policies for code L89.301?