What insurance policy changes affect code O24.93?

There are 3 tracked policy changes affecting code O24.93, including updates from Aetna, Excellus BlueCross BlueShield. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code O24.93?

Payers that have issued tracked updates for code O24.93 include: Aetna, Excellus BlueCross BlueShield.

How do I get notified when code O24.93 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code O24.93. 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 O24.93?

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

O24.93 Insurance Policy Changes

ICD-10 O24.93 is officially defined as "Unspecified diabetes mellitus in the puerperium." code O24.93 is referenced in 3 tracked payer policy changes from Aetna and Excellus BlueCross BlueShield. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code O24.93 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Effective May 31, 2026High impact
Remote Physiologic Monitoring (RPM) (CPB 1093, reviewed 2026-05-31)
Aetna has clarified its Remote Physiologic Monitoring (RPM) coverage policy (CPB 1093, effective 2026-05-31) establishing strict medical necessity criteria for three conditions: heart failure, hypertension, and diabetes. RPM is now only covered when using FDA-approved devices with automatic data transmission, documented patient consent, provider ordering/supervision, and clinical impact on treatment plans. Coverage is limited to one episode per patient per condition per provider per month. Billing teams must verify all criteria are met before submitting claims and ensure documentation supports medical necessity.
Excellus BlueCross BlueShield · Effective Jan 1, 2026High impact
Continuous Glucose Monitoring Systems/External Insulin Pump Therapy for Diabetes 1.01.30
Excellus BlueCross BlueShield medical policy 1.01.30 expanded its criteria for insulin pump requests to include members who use continuous glucose monitoring rather than finger sticks. The December 18, 2025 annual review removed insulin dependency requirements and states that disposable external insulin pumps are no longer investigational. The May 22, 2025 update had changed the initial pump self-testing requirement from four times a day to three times per day, and the prior initiation requirement from two months to one month.
Aetna · Identified Oct 26, 2026Medium impact
Remote Physiologic Monitoring (RPM) (CPB 1093, reviewed 2026-06-01)
Aetna Clinical Policy Bulletin 1093 on remote physiologic monitoring (RPM), reviewed 2026-06-01, considers RPM medically necessary when all listed criteria are met, including a member with heart failure, hypertension or diabetes, an FDA-approved or cleared device capable of automatic data transmission, and documentation of patient consent in the medical record. The policy considers RPM experimental, investigational or unproven for conditions other than those listed, and for RPM using devices not approved or cleared by the FDA, and it states that coverage is limited to one episode of RPM per patient per condition per provider per month.

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Remote Physiologic Monitoring (RPM) (CPB 1093, reviewed 2026-05-31)

Continuous Glucose Monitoring Systems/External Insulin Pump Therapy for Diabetes 1.01.30

Remote Physiologic Monitoring (RPM) (CPB 1093, reviewed 2026-06-01)

What insurance policy changes affect code O24.93?

Which payers have updated policy for code O24.93?

How do I get notified when code O24.93 policy changes?

Why do payers change policies for code O24.93?