What insurance policy changes affect code M31.6?

There are 4 tracked policy changes affecting code M31.6, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code M31.6?

Payers that have issued tracked updates for code M31.6 include: Aetna.

How do I get notified when code M31.6 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code M31.6. 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 M31.6?

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

M31.6 Insurance Policy Changes

ICD-10 M31.6 is officially defined as "Other giant cell arteritis." code M31.6 is referenced in 4 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 M31.6 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Oct 19, 2026Medium impact
Headaches: Invasive Procedures (CPB 0707, reviewed 2026-10-15)
Aetna's Clinical Policy Bulletin 0707 covers greater occipital nerve block for occipital neuralgia and other headaches, including migraines, when selection criteria are met. It considers many other headache procedures experimental, investigational, or unproven, including cervicogenic headache treatments, cryo-denervation, radiofrequency denervation of cervical facet joints, and sphenopalatine ganglion procedures for cluster headache and other chronic headaches. Botulinum toxin is considered medically necessary for chronic migraine when the criteria in CPB 0113 are met.
Aetna · Identified Aug 16, 2026Medium impact
Headaches: Invasive Procedures (CPB 0707, reviewed 2026-07-23)
Aetna considers greater occipital nerve block (CPT 64405) medically necessary for the management of occipital nerve neuralgia and other headaches, including migraines. CPT 64405 is not covered for cluster headache and other chronic headaches, including chronic migraines. Aetna considers many other invasive headache procedures experimental, investigational, or unproven because their effectiveness has not been established, including cervicogenic headache procedures, cervical facet radiofrequency denervation, occipital nerve stimulation, vagus nerve stimulation, and migraine trigger site surgery. Temporal artery biopsy is considered medically necessary for diagnosis of suspected temporal arteritis.
Aetna · Identified Aug 14, 2026Medium impact
Transcranial Doppler Ultrasonography (CPB 0353, reviewed 2026-05-22)
Aetna considers transcranial Doppler ultrasonography medically necessary for indications including assessing collateral blood flow and embolization during carotid endarterectomy, evaluating persons with suspected brain death, detecting microemboli after stroke or transient ischemic attack, evaluating giant cell arteritis, and assessing stroke risk in children aged 2 to 16 years with sickle cell anemia. Aetna considers it experimental, investigational, or unproven for all other indications, including screening for carotid artery stenosis in asymptomatic adults, managing traumatic brain injury, migraine headaches, epilepsy, and evaluating adults with sickle cell anemia. The covered CPT codes are 93886, 93888, 93890, 93892, 93893, 93896, 93897 and 93898 when selection criteria are met.
Aetna · Identified Aug 12, 2026Medium impact
Optical Coherence Tomography of the Head and Neck (CPB 0928, reviewed 2025-12-30)
Optical coherence tomography (OCT) of the head and neck is considered experimental, investigational or unproven for these uses because their effectiveness has not been established: annual OCT follow-up of thyroid ophthalmopathy after orbital decompression, dynamic OCT for actinic keratosis, endoscopic OCT for tympanoplasty, intra-operative wide-field OCT for deep margins in head and neck surgery, OCT for the middle ear, OCT for diagnosis of oral cancerous lesions, OCT for evaluation of voice disorders, OCT for monitoring radiation-induced skin changes in head and neck cancer, OCT angiography for detecting subclinical low perfusion in giant cell arteritis without manifest ocular involvement and in thyroid-associated ophthalmopathy, and OCT otoscopes for imaging the tympanic membrane and middle ear. CPT 0485T through 0486T, 92133 and 92134 are listed as not covered for the indications in this policy, and so are ICD-10 codes for head and neck cancer, thyroid eye disease, tympanic membrane and middle ear disorders, actinic keratosis, radiation-induced skin changes, giant cell arteritis, voice and resonance disorders, and oral cavity cancer screening.

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Headaches: Invasive Procedures (CPB 0707, reviewed 2026-10-15)

Headaches: Invasive Procedures (CPB 0707, reviewed 2026-07-23)

Transcranial Doppler Ultrasonography (CPB 0353, reviewed 2026-05-22)

Optical Coherence Tomography of the Head and Neck (CPB 0928, reviewed 2025-12-30)

What insurance policy changes affect code M31.6?

Which payers have updated policy for code M31.6?

How do I get notified when code M31.6 policy changes?

Why do payers change policies for code M31.6?