N17.0 Insurance Policy Changes

ICD-10 N17.0 is officially defined as "Acute kidney failure with tubular necrosis." code N17.0 is referenced in 11 tracked payer policy changes from Aetna and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code N17.0 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Nov 4, 2026Medium impact
Selected Kidney Function Tests (CPB 0775, reviewed 2026-10-28)
Aetna's Clinical Policy Bulletin 0775 (reviewed 2026-10-28) designates multiple advanced kidney function tests as experimental, investigational, or unproven, including KidneyIntelX, IntelxDKD, NaviDKD, PromarkerD, RenalVysion, RenaDx, RenaXome, GFR NMR, APOL1 genotyping, and transdermal pyrazine-based GFR measurement. Claims for these tests will be denied when billed with the specified CPT codes and ICD-10 indications listed in the policy.
Aetna · Identified Oct 29, 2026Medium impact
Transcatheter Aortic Valve Implantation (CPB 0826, reviewed 2026-10-28)
Aetna considers transcatheter aortic valve implantation (TAVI) medically necessary when criteria are met. Those criteria cover severe symptomatic calcified native aortic valve stenosis without severe aortic insufficiency and an ejection fraction greater than 20%, and valve-in-valve replacement of a degenerated bioprosthetic aortic valve in patients with a Society of Thoracic Surgeons operative risk score of 8% or greater or a judged 15% or greater risk of mortality from surgical replacement. Percutaneous repair of prosthetic paravalvular leak is also considered medically necessary under specific conditions, while BASILICA, combined TAVI and left atrial appendage occlusion, embolic protection devices, TAVI for ongoing sepsis or endocarditis, and several prognostic tests are listed as experimental, investigational or unproven.
Aetna · Identified Oct 4, 2026Medium impact
Autologous Skeletal Myoblast/Mononuclear Bone Marrow Cell Transplantation (CPB 0599, reviewed 2026-09-18)
Autologous skeletal myoblast transplantation, intra-coronary and intra-myocardial autologous bone marrow cell transplantation, and intra-arterial or intra-muscular autologous mononuclear bone marrow cell transplantation are considered experimental, investigational, or unproven because effectiveness has not been established. Autologous or allogeneic bone marrow-derived mesenchymal stem cell transplantation is likewise considered experimental, investigational, or unproven for conditions including acute myocardial infarction, diabetes, multiple sclerosis, knee osteoarthritis, spinal cord injury, rheumatoid arthritis, Crohn's disease, and peripheral nerve repair. CPT codes 0263T, 0264T, 0265T, 38240, and 38241 and HCPCS code C9782 are listed as not covered for the listed indications, and the ICD-10 codes for those indications are listed as not covered for these services.
Aetna · Identified Oct 2, 2026Medium impact
Cardiovascular Monitoring Equipment for Home Use: Pulse, Blood Pressure, Telemonitors, and Pacemaker Monitors (CPB 0548, reviewed 2026-08-21)
Aetna considers validated home blood pressure monitors medically necessary as an alternative to ambulatory blood pressure monitoring to confirm hypertension in members age 18 and older with office readings greater than 140 systolic or 90 diastolic. Validated blood pressure monitors are considered medically necessary for members receiving hemodialysis or peritoneal dialysis in the home, and validated blood pressure cuffs are considered medically necessary durable medical equipment for members with hypertension. Self-contained pacemaker monitors, including audible and visible signal monitors, digital electronic monitors, and a specialized telephone attachment for trans-telephonic transmission of results, are considered medically necessary for members with cardiac pacemakers. Automated oscillometer serial blood pressure monitors for home use, AngelMed Guardian, CardioMEMS pillow and components, home and implantable congestive heart failure monitors, implantable inferior vena cava sensors, implantable wireless pulmonary artery pressure monitors for heart failure, Zoll Heart Failure and Arrhythmia Management System, bioelectrical impedance analysis, and non-invasive central blood pressure assessment with SphygmoCor are considered experimental, investigational, or unproven. Pulse tachometers do not meet Aetna's definition of covered durable medical equipment.
Aetna · Identified Aug 18, 2026Medium impact
Transcatheter Aortic Valve Implantation (CPB 0826, reviewed 2025-12-03)
Aetna Clinical Policy Bulletin 0826 covers transcatheter aortic valve implantation (TAVI). Aetna considers TAVI with an FDA-approved valve medically necessary for severe symptomatic calcified native aortic valve stenosis without severe aortic insufficiency and with an ejection fraction greater than 20%, and for valve-in-valve replacement of a degenerated bioprosthetic aortic valve when the STS operative risk score is 8% or greater or the member is judged to be at 15% or greater risk of mortality for surgical aortic valve replacement. Percutaneous repair of prosthetic paravalvular leak is medically necessary when intractable hemolysis or NYHA class III or IV symptoms, high or prohibitive surgical risk, suitable anatomy and a comprehensive valve center are all met, and BASILICA, combined TAVI and left atrial appendage occlusion, pre-implantation balloon aortic valvuloplasty, embolic protection devices, and TAVI for sepsis, bicuspid aortic stenosis, native aortic valve regurgitation or porcelain aorta are listed as experimental, investigational or unproven.
Aetna · Identified Aug 16, 2026Medium impact
Selected Kidney Function Tests (CPB 0775, reviewed 2026-07-31)
Aetna considers these kidney function tests experimental, investigational, or unproven because their effectiveness has not been established: APOL1 renal risk variant genotyping, the GFRNMR test, KidneyIntelX and IntelxDKD, NaviDKD, PromarkerD, the RenaDx Comprehensive Renal Disease Panel, RenalVysion, RenaXome, and transdermal fluorescent pyrazine agents for measuring glomerular filtration rate. CPT code 0105U is not covered for KidneyIntelX, 0407U for IntelxDKD, 0259U for GFRNMR, 0355U for APOL1 genotyping, 0384U and 0385U for NaviDKD and PromarkerD, 0628U for the RenaDx panel, 0653U for RenaXome, and 0602T and 0603T for the transdermal GFR system, for the indications listed. RenalVysion has no specific CPT codes in the policy.
Aetna · Identified Aug 15, 2026Medium impact
Cardiovascular Monitoring Equipment for Home Use: Pulse, Blood Pressure, Telemonitors, and Pacemaker Monitors (CPB 0548, reviewed 2025-08-22)
Aetna considers validated home blood pressure monitors medically necessary as an alternative to ambulatory blood pressure monitoring to confirm hypertension in members age 18 and older with office readings greater than 140 systolic or 90 diastolic, when the cuff is prescribed by a physician, is an arm device, has the correct cuff size assessed and provided by the vendor, and only one cuff per 5 years is considered medically necessary. Validated blood pressure monitors are also considered medically necessary for members receiving hemodialysis or peritoneal dialysis in the home, and self-contained pacemaker monitors are considered medically necessary for members with cardiac pacemakers. Pulse tachometers do not meet Aetna's definition of covered DME, and the following are considered experimental, investigational, or unproven: AngelMed Guardian, automated oscillometer serial blood pressure monitors for home use, bioelectrical impedance analysis, CardioMEMS, home congestive heart failure telemonitoring devices, implantable congestive heart failure monitors, the implantable inferior vena cava sensor, non-invasive central blood pressure assessment with the SphygmoCor System, and the Zoll Heart Failure and Arrhythmia Management System for monitoring pulmonary fluid levels. The bulletin is titled CPB 0548, reviewed 2025-08-22, with a last review of 08/21/2026.
Aetna · Identified Aug 13, 2026Medium impact
Crit-Line In-Line Monitor (CPB 0373, reviewed 2026-05-26)
Aetna considers the Crit-Line In-Line Monitor experimental, investigational, or unproven for monitoring hematocrit and oxygen saturation of members. The policy states that the monitor's effectiveness in avoiding intra-dialytic morbid events, in preventing ischemia due to intra-dialytic hypoxia, and in determining access re-circulations has not been proven. The policy lists no specific CPT or HCPCS code for the Crit-Line In-Line Monitor.
Aetna · Identified Aug 13, 2026Medium impact
Plerixafor (CPB 0779, reviewed 2026-02-13)
Aetna's policy covers plerixafor (Mozobil or generic plerixafor) for hematopoietic stem cell mobilization when it is given after a granulocyte-colony stimulating factor such as filgrastim, after chemo-mobilization, or as part of a gene therapy protocol, and when it is not used beyond 4 consecutive days or after stem cell harvest or apheresis is complete. Continuation of therapy is considered medically necessary for members who meet the initial selection criteria. Aetna considers plerixafor experimental, investigational or unproven for all other indications, including the conditions listed in the policy such as acute leukemias, sickle cell disease, WHIM syndrome and neutropenia treatment.
Aetna · Identified Aug 12, 2026Medium impact
Automated Ambulatory Blood Pressure Monitoring (CPB 0025, reviewed 2026-03-12)
Aetna considers automated ambulatory blood pressure monitoring medically necessary when a member meets one of the listed criteria: at least two elevated office readings taken on separate days to identify 'white coat' hypertension; episodic hypertension with symptoms suggesting an adrenal tumor and repeatedly normal office readings; hypotensive symptoms or syncope thought related to antihypertensive medications; syncope evaluated with a 24-hour Holter monitor; nocturnal angina; resistant hypertension before an invasive investigation for secondary causes; or autosomal dominant polycystic kidney disease in children and young adults 30 years of age or younger. Monitoring for less than 24 hours or more than 3 days is not considered medically necessary, and repeat testing is not generally necessary more often than every 6 months. Aetna considers the use experimental, investigational, or unproven for heart failure, for pregnant women who do not meet the criteria, for diagnosing malignant hypertension, for members with an irregular cardiac rhythm such as atrial fibrillation, for routine monitoring to establish a hypertension diagnosis or evaluate treatment response, and for routine use before continuous positive airway pressure (CPAP) therapy.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Continuous Arteriovenous Hemofiltration
Continuous renal replacement therapy may be considered medically necessary as supportive treatment for acute renal failure. CPT 90945 and 90947 cover dialysis procedures other than hemodialysis, including hemofiltration and other continuous renal replacement therapies. The policy was reviewed on 01/14/2026 with its policy statement unchanged, and ICD-9 diagnosis codes were removed from the code reference.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code N17.0?

There are 11 tracked policy changes affecting code N17.0, including updates from Aetna, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code N17.0?

Payers that have issued tracked updates for code N17.0 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code N17.0 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code N17.0. 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 N17.0?

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.

All billing codes J3590 C9399 J3490 99215 99213 99202

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Selected Kidney Function Tests (CPB 0775, reviewed 2026-10-28)

Transcatheter Aortic Valve Implantation (CPB 0826, reviewed 2026-10-28)

Autologous Skeletal Myoblast/Mononuclear Bone Marrow Cell Transplantation (CPB 0599, reviewed 2026-09-18)

Cardiovascular Monitoring Equipment for Home Use: Pulse, Blood Pressure, Telemonitors, and Pacemaker Monitors (CPB 0548, reviewed 2026-08-21)

Transcatheter Aortic Valve Implantation (CPB 0826, reviewed 2025-12-03)

Selected Kidney Function Tests (CPB 0775, reviewed 2026-07-31)

Cardiovascular Monitoring Equipment for Home Use: Pulse, Blood Pressure, Telemonitors, and Pacemaker Monitors (CPB 0548, reviewed 2025-08-22)

Crit-Line In-Line Monitor (CPB 0373, reviewed 2026-05-26)

Plerixafor (CPB 0779, reviewed 2026-02-13)

Automated Ambulatory Blood Pressure Monitoring (CPB 0025, reviewed 2026-03-12)

Continuous Arteriovenous Hemofiltration

What insurance policy changes affect code N17.0?

Which payers have updated policy for code N17.0?

How do I get notified when code N17.0 policy changes?

Why do payers change policies for code N17.0?