What insurance policy changes affect code Q87.40?

There are 5 tracked policy changes affecting code Q87.40, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code Q87.40?

Payers that have issued tracked updates for code Q87.40 include: Aetna.

How do I get notified when code Q87.40 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code Q87.40. 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 Q87.40?

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

Q87.40 Insurance Policy Changes

ICD-10 Q87.40 is officially defined as "Marfan syndrome, unspecified." code Q87.40 is referenced in 5 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 Q87.40 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Oct 4, 2026Medium impact
Genetic Testing (CPB 0140, reviewed 2026-08-18)
Aetna covers genetic testing only when the criteria for the specific condition are met, and it considers testing outside those criteria experimental, investigational, or unproven, including testing for Parkinson disease, essential tremor, coronary artery disease (except testing for familial hypercholesterolemia), and type 2 diabetes other than MODY. Multi-gene panels for inherited cancers are covered only for members with a personal or family history of a related cancer when more than one inherited cancer syndrome could explain the presentation and the panel is more efficient than separate tests, and genetic testing for inherited cancers is a once-in-a-lifetime benefit. Expanded carrier screening for people who are pregnant or planning a pregnancy is covered when the panel includes cystic fibrosis, spinal muscular atrophy, and/or hemoglobinopathies, unless previously performed, and the results will be used in managing the pregnancy or for family planning; whole exome or whole genome sequencing is covered for an unexplained congenital or neurodevelopmental disorder when its listed criteria are met, and whole genome sequencing after a non-diagnostic whole exome test is considered not medically necessary.
Aetna · Identified Aug 17, 2026Medium impact
Fetal Echocardiography and Magnetocardiography (CPB 0106, reviewed 2026-03-26)
Aetna considers fetal echocardiograms, Doppler and color flow mapping after 12 weeks gestation medically necessary for listed indications. These include a mother with type 1 diabetes or pregestational type 2 diabetes on insulin during the first trimester, a mother with systemic lupus erythematosus, a fetal nuchal translucency of 3.5 mm or greater in the first trimester, pregnancies conceived by IVF or ICSI, monochorionic twins, suspected twin-twin transfusion syndrome, suspected or documented fetal arrhythmia, suspected or known fetal chromosomal abnormalities, single umbilical artery, persistent right umbilical vein, non-immune fetal hydrops or unexplained severe polyhydramnios, and seizure disorders in members even if they are not taking anti-seizure medication. Fetal exposure to anti-seizure medications, excessive alcohol, lithium, paroxetine or retinoids is also a listed indication. Repeat studies are covered for listed findings and for fetal surveillance of anti-Ro (SSA) or anti-La (SSB) exposure, which may be repeated every 1 to 2 weeks starting at 16 weeks gestation through 28 weeks, then every other week until 32 weeks. Fetal echocardiograms for advanced maternal age screening, gestational diabetes even if requiring insulin after the first trimester, modafinil exposure, selective serotonin reuptake inhibitors except paroxetine, tacrolimus, a tortuous ductus arteriosus, and suspected cystic fibrosis are experimental, investigational or unproven. Fetal magnetocardiography and deep learning-based models for diagnosing fetal arrhythmia are also experimental, investigational or unproven.
Aetna · Identified Aug 16, 2026Medium impact
RET Proto-Oncogene Testing (CPB 0319, reviewed 2026-06-08)
Aetna considers germline RET proto-oncogene testing medically necessary for members with a personal history of medullary thyroid carcinoma (familial or apparently sporadic), pheochromocytoma or paraganglioma when multiple endocrine neoplasia type 2 (MEN2) is suspected, parathyroid adenoma or hyperplasia when MEN2A is suspected, C-cell hyperplasia on pathology, or clinical features of MEN2B. Family history criteria include a first-degree blood relative with medullary thyroid carcinoma, a first-degree or second-degree blood relative with a known germline RET pathogenic variant, and a family pattern consistent with familial medullary thyroid carcinoma. Germline RET testing for all other indications, such as non-small cell lung cancer, is considered experimental, investigational, or unproven.
Aetna · Identified Aug 15, 2026Medium impact
Corneal Pachymetry (CPB 0681, reviewed 2025-10-15)
Aetna considers ultrasound corneal pachymetry (CPT 76514) medically necessary for listed indications, including keratoconus, Fuchs' endothelial dystrophy, corneal edema, bullous keratopathy, corneal transplant and corneal refractive surgery evaluations, narrow angles, and glaucoma or glaucoma suspects, with the glaucoma indication covered once per lifetime. Repeat pachymetry for corneal diseases and injuries is not medically necessary if performed more frequently than once every 6 months. Screening for glaucoma without signs or symptoms, diagnosis of Marfan syndrome, pterygium management and monitoring on hydroxychloroquine are listed as experimental, investigational or unproven.
Aetna · Identified Nov 3, 2026Low impact
Corneal Pachymetry (CPB 0681, reviewed 2026-10-26)
This is Aetna's clinical policy bulletin on ultrasound corneal pachymetry (corneal thickness measurement), CPB 0681, last reviewed October 26, 2026. It lists the indications where the test is considered medically necessary, the uses Aetna considers experimental, and a limit of one repeat test every six months for corneal diseases and injuries. The text does not describe a new rule with a stated effective date, so treat it as current policy language and confirm with Aetna before relying on it.

Watch Q87.40

Get one email when a payer policy names Q87.40, 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

Genetic Testing (CPB 0140, reviewed 2026-08-18)

Fetal Echocardiography and Magnetocardiography (CPB 0106, reviewed 2026-03-26)

RET Proto-Oncogene Testing (CPB 0319, reviewed 2026-06-08)

Corneal Pachymetry (CPB 0681, reviewed 2025-10-15)

Corneal Pachymetry (CPB 0681, reviewed 2026-10-26)

What insurance policy changes affect code Q87.40?

Which payers have updated policy for code Q87.40?

How do I get notified when code Q87.40 policy changes?

Why do payers change policies for code Q87.40?