What insurance policy changes affect code M26.89?

There are 2 tracked policy changes affecting code M26.89, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code M26.89?

Payers that have issued tracked updates for code M26.89 include: Aetna.

How do I get notified when code M26.89 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code M26.89. 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 M26.89?

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

M26.89 Insurance Policy Changes

ICD-10 M26.89 is officially defined as "Other dentofacial anomalies." code M26.89 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 M26.89 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 Oct 2, 2026Medium impact
Extracorporeal Shock-Wave Therapy for Musculoskeletal Indications and Soft Tissue Injuries (CPB 0649, reviewed 2026-09-14)
Aetna clinical policy bulletin 0649 (reviewed September 14, 2026) considers extracorporeal shock-wave therapy medically necessary only for calcific tendinopathy of the shoulder that has lasted at least 6 months, has a calcium deposit of 1 cm or more, and has not responded to conservative care. It lists many other musculoskeletal, pain, wound and scar indications as experimental or not covered. The source gives a review date but no effective date, so confirm current applicability before changing workflows.
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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Extracorporeal Shock-Wave Therapy for Musculoskeletal Indications and Soft Tissue Injuries (CPB 0649, reviewed 2026-09-14)

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

What insurance policy changes affect code M26.89?

Which payers have updated policy for code M26.89?

How do I get notified when code M26.89 policy changes?

Why do payers change policies for code M26.89?