What insurance policy changes affect code M75.42?

There are 2 tracked policy changes affecting code M75.42, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code M75.42?

Payers that have issued tracked updates for code M75.42 include: Aetna.

How do I get notified when code M75.42 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code M75.42. 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 M75.42?

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

M75.42 Insurance Policy Changes

ICD-10 M75.42 is officially defined as "Impingement syndrome of left shoulder." code M75.42 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 M75.42 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
Phonophoresis (CPB 0210, reviewed 2026-03-27)
Aetna considers phonophoresis experimental, investigational, or unproven for all indications, including adhesive capsulitis, carpal tunnel syndrome, knee osteoarthritis, low back pain, neck pain, sinusitis, chronic obstructive pulmonary disease, and venous and diabetic ulcers, because its effectiveness has not been established. Controlled clinical trials have failed to demonstrate that phonophoresis increases the rate or extent of absorption of analgesics and anti-inflammatory agents. Bee venom phonophoresis and Contractubex phonophoresis are listed as not covered for the indications in the policy.
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.

Watch M75.42

Get one email when a payer policy names M75.42, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

Get alerts for changes like this

Save a search and get email alerts when a new policy change matches your filters: daily or weekly, your choice, on every plan.

Create a free alert How Policy Monitoring works

Phonophoresis (CPB 0210, reviewed 2026-03-27)

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

What insurance policy changes affect code M75.42?

Which payers have updated policy for code M75.42?

How do I get notified when code M75.42 policy changes?

Why do payers change policies for code M75.42?