What insurance policy changes affect code L89.95?

There are 6 tracked policy changes affecting code L89.95, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code L89.95?

Payers that have issued tracked updates for code L89.95 include: Aetna.

How do I get notified when code L89.95 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code L89.95. 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 L89.95?

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

L89.95 Insurance Policy Changes

ICD-10 L89.95 is officially defined as "Pressure ulcer of unspecified site, unstageable." code L89.95 is referenced in 6 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 L89.95 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Oct 21, 2026Medium impact
Ultrasound Therapy for Wound Healing (CPB 0746, reviewed 2026-10-16)
Aetna considers ultrasound therapy, including high-frequency ultrasound and non-contact low-frequency ultrasound devices, experimental, investigational, or unproven for wound healing and for reduction of chronic wound pain, because the effectiveness of this approach for these indications has not been established. CPT 97610, low-frequency non-contact non-thermal ultrasound per day, is listed as not covered for the indications in this policy. Examples of ultrasound therapy named in this policy include the FAST procedure, the MIST Therapy System, the Qoustic Wound Therapy System, and the Sonoca 180/185 Wound Care System.
Aetna · Identified Oct 17, 2026Medium impact
Electrical Stimulation for Chronic Ulcers (CPB 0680, reviewed 2026-10-14)
Aetna considers electrical stimulation medically necessary durable medical equipment for arterial ulcers, diabetic ulcers, Stage III or IV pressure ulcers, and venous stasis ulcers when it is used as adjunctive therapy after no measurable signs of healing for at least 30 days of conventional wound treatment. Courses exceeding 1 hour per day are not considered medically necessary, continued stimulation is not medically necessary if measurable healing is not shown within a 4-week treatment period or once the wound bed is 100% epithelialized, and electrical stimulation for chronic ulcers in the home setting is considered not medically appropriate. Aetna considers electrical stimulation experimental, investigational, or unproven for uses including prevention of ulcers and pressure sores, infected wounds, microcurrent as an adjunctive therapy, and the VeinoPlus device for venous ulcers.
Aetna · Identified Oct 5, 2026Medium impact
Infrared Therapy (CPB 0604, reviewed 2026-09-09)
Aetna considers infrared coagulation medically necessary for anal dysplasia and for members with grade I, II, or III internal hemorrhoids that are painful or persistently bleeding. Low-level infrared light therapy is considered experimental, investigational, or unproven for a long list of indications, including osteoarthritis, migraines, stroke, and diabetes mellitus, and the infrared glove is unproven for Raynaud's syndrome and all other indications. CPT 46930 is covered when selection criteria are met, while CPT 97026 and HCPCS codes A4639 and E0221 are not covered for the listed indications.
Aetna · Identified Aug 19, 2026Medium impact
Wound Imaging and Noninvasive Wound Therapy (CPB 0372, reviewed 2026-05-21)
Aetna considers the Clarifi Imaging System, concurrent optical and magnetic stimulation (COMS) therapy for chronic leg and foot ulcers, the DeepView Wound Imaging System for burn assessment and wound healing prediction, the MolecuLight hand-held device for point-of-care fluorescence imaging of wounds, noncontact nonthermal low-frequency ultrasound therapy for wounds and all other indications, and Warm-Up Active Wound Therapy (noncontact normothermic wound therapy) experimental, investigational, or unproven. Several CPT, HCPCS, and ICD-10 codes are listed as not covered for the indications in the bulletin.
Aetna · Identified Aug 18, 2026Medium impact
Ultrasound Therapy for Wound Healing (CPB 0746, reviewed 2025-11-26)
Aetna considers ultrasound therapy for wound healing and for reduction of chronic wound pain experimental, investigational, or unproven, because its effectiveness for these indications has not been established. This includes high-frequency ultrasound and non-contact low-frequency ultrasound devices, such as the MIST Therapy System, the Qoustic Wound Therapy System, and the Sonoca 180/185 Wound Care System. CPT 97610 is listed as not covered for the indications in this policy.
Aetna · Identified Sep 29, 2026Low impact
Bio-Surgery: Medicinal Leech Therapy and Medical Maggots (CPB 0556, reviewed 2026-09-01)
Aetna's bio-surgery policy (CPB 0556, reviewed September 1, 2026) sets when medicinal leech therapy and medical maggots (bagged larval therapy) are covered, mainly for specific chronic wounds, flap and replant salvage. It lists many other uses, including knee and thumb osteoarthritis, low back pain and burns, as experimental, and the source gives a review date but no effective date.

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Ultrasound Therapy for Wound Healing (CPB 0746, reviewed 2026-10-16)

Electrical Stimulation for Chronic Ulcers (CPB 0680, reviewed 2026-10-14)

Infrared Therapy (CPB 0604, reviewed 2026-09-09)

Wound Imaging and Noninvasive Wound Therapy (CPB 0372, reviewed 2026-05-21)

Ultrasound Therapy for Wound Healing (CPB 0746, reviewed 2025-11-26)

Bio-Surgery: Medicinal Leech Therapy and Medical Maggots (CPB 0556, reviewed 2026-09-01)

What insurance policy changes affect code L89.95?

Which payers have updated policy for code L89.95?

How do I get notified when code L89.95 policy changes?

Why do payers change policies for code L89.95?