R00.2 Insurance Policy Changes

ICD-10 R00.2 is officially defined as "Palpitations." code R00.2 is referenced in 9 tracked payer policy changes from Blue Shield of California, Excellus BlueCross BlueShield, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code R00.2 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Blue Shield of California · Effective Aug 1, 2026High impact
Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry (2.02.08)
Blue Shield of California medical policy 2.02.08, Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry, has an effective date of August 1, 2026. Outpatient cardiac telemetry (mobile cardiac outpatient telemetry, MCOT) may be considered medically necessary as a diagnostic alternative to ambulatory event monitors for infrequent symptoms (less frequently than every 48 hours) suggestive of cardiac arrhythmias, such as severe palpitations, dizziness, or clinically significant presyncope or syncope, when the criteria below are met. Under the prior policy statement this use was considered investigational. Outpatient cardiac telemetry for any other condition, disease or symptoms, and ambulatory event monitors for asymptomatic individuals with risk factors for arrhythmia, are considered investigational.
Excellus BlueCross BlueShield · Effective Jul 16, 2026Medium impact
Cardiac Event Monitors 2.01.03
External intermittent cardiac event monitors are medically appropriate for symptoms possibly related to rhythm disturbances (such as palpitations, or serious or significant syncope and near syncope), after an ablation, and after starting or stopping anti-arrhythmic drug therapy, when the specific criteria are met. Implantable loop recorders may be considered medically appropriate for specified indications, such as infrequent recurrent syncope, near syncope, or palpitations, paroxysmal atrial fibrillation, cryptogenic stroke, and post cardiac ablation, when the criteria are met, and home-based mobile cardiac outpatient telemetry is considered not medically necessary. External monitoring to measure heart rate variability or to detect ST segment changes, and intracardiac ischemia event monitors, are investigational.
Aetna · Identified Sep 30, 2026Medium impact
Percutaneous Transluminal Septal Myocardial Ablation (PTSMA) (CPB 0558, reviewed 2026-08-21)
Aetna considers alcohol septal ablation (PTSMA) medically necessary for adults 21 years of age and older with hypertrophic obstructive cardiomyopathy when all listed criteria are met, including a clinical diagnosis of hypertrophic cardiomyopathy by echocardiography or cardiovascular MRI, severe symptoms that interfere with activities of daily living despite optimal drug therapy, NYHA functional class III or IV, and a peak LVOT gradient of 50 mm Hg or more. Aetna also considers PTSMA medically necessary for carefully selected members aged 5 to 20 with HOCM who meet separate pediatric criteria, and considers PTSMA for all other indications, SESAME, and ultrasound-guided PTSMA experimental, investigational, or unproven.
Aetna · Identified Aug 18, 2026Medium impact
Holter Monitors (CPB 0019, reviewed 2026-03-13)
Aetna considers Holter monitoring medically necessary for diagnostic evaluation of adult members with listed conditions, including palpitations, syncope or near syncope, unexplained dizziness, and possible or documented long QT syndrome, and for asymptomatic congenital complete atrioventricular block in pediatric patients. Holter monitoring is considered experimental, investigational, or unproven for all other indications because its effectiveness for those indications has not been established. CPT codes 93224, 93225, 93226 and 93227 are covered if the selection criteria are met.
Aetna · Identified Aug 15, 2026Medium impact
Cardiac Event Monitors (CPB 0073, reviewed 2026-04-07)
Aetna considers external intermittent cardiac event monitors, external ECG monitoring for greater than 48 hours by continuous rhythm recording (such as the Zio Patch), mobile cardiovascular telemetry, and implantable loop recorders medically necessary when the listed criteria are met. The criteria cover syncope, lightheadedness, presyncope, palpitations and dizziness, and suspected atrial fibrillation as a cause of cryptogenic stroke, in members with a non-diagnostic Holter monitor or 48 hour telemetry or with symptoms that occur less often than daily. Aetna considers these monitors experimental, investigational, or unproven for all other indications, and it lists several handheld and self-monitoring ECG devices, including Kardia Mobile, Kardia 12L, KardiaMobile 6L, BodyGuardian, iHEART and the ViSi Mobile Monitoring System, as experimental, investigational, or unproven.
Aetna · Identified Aug 14, 2026Medium impact
Intensive Cardiac Rehabilitation Programs (CPB 0267, reviewed 2026-05-14)
Aetna considers intensive cardiac rehabilitation programs (the Benson-Henry Institute Cardiac Wellness Program, the Ornish cardiac treatment program and the Pritikin Program) medically necessary as an alternative to traditional Phase II cardiac rehabilitation for members who meet the cardiac rehabilitation criteria, limited to 72 one-hour sessions, up to 6 per day, over a period of up to 18 weeks. Virtual delivery by real-time audio and video (excluding audio-only) is considered medically necessary when the telehealth program and member criteria are met, but hospital outpatient departments are not eligible for virtual telehealth services. Intensive cardiac rehabilitation is considered experimental, investigational or unproven for diabetes, hyperlipidemia, prostate cancer, metabolic syndrome and all other indications where effectiveness has not been established.
Aetna · Identified Aug 13, 2026Medium impact
Percutaneous Transluminal Septal Myocardial Ablation (PTSMA) (CPB 0558, reviewed 2026-02-19)
Aetna Clinical Policy Bulletin 0558 considers percutaneous transluminal septal myocardial ablation (PTSMA) by alcohol-induced septal branch occlusion medically necessary for hypertrophic obstructive cardiomyopathy (HOCM) in adults 21 years of age and older when all listed criteria are met, including severe symptoms despite optimal drug therapy, NYHA class III or IV, a peak LVOT gradient of at least 50 mm Hg, and suitable coronary anatomy with an identifiable septal perforator artery. Aetna also considers PTSMA medically necessary for carefully selected members 5 to 20 years of age with HOCM when the pediatric criteria are met, and it considers PTSMA for all other indications, SESAME, and ultrasound-guided PTSMA experimental, investigational, or unproven.
Independence Blue Cross · Identified Jun 19, 2026Low impact
06.02.31g, Genetic Testing for Congenital Long QT Syndrome (Independence Administrators)
This is a routine annual reissue of Independence Administrators' genetic testing policy for congenital Long QT Syndrome with no substantive changes to coverage criteria or billing codes. The policy clarifies that it applies only to members whose groups have NOT enrolled in the UM vendor program; groups with UM vendor enrollment should refer to the eviCore Lab Management Program instead.
Independence Blue Cross · Identified Jun 19, 2026Low impact
06.02.31g, Genetic Testing for Congenital Long QT Syndrome (Independence Administrators)
This is a reissue of policy 06.02.31g with no substantive changes to coverage criteria for genetic testing of congenital Long QT Syndrome. The only modification is clarification of the applicability disclaimer: the policy now explicitly excludes groups enrolled in the UM vendor program, replacing the previous reference to eviCore Lab Management Program. Billing teams should verify member eligibility and UM vendor enrollment status before processing genetic testing claims.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code R00.2?

There are 9 tracked policy changes affecting code R00.2, including updates from Blue Shield of California, Excellus BlueCross BlueShield, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code R00.2?

Payers that have issued tracked updates for code R00.2 include: Blue Shield of California, Excellus BlueCross BlueShield, Aetna, Independence Blue Cross.

How do I get notified when code R00.2 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code R00.2. 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 R00.2?

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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Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry (2.02.08)

Cardiac Event Monitors 2.01.03

Percutaneous Transluminal Septal Myocardial Ablation (PTSMA) (CPB 0558, reviewed 2026-08-21)

Holter Monitors (CPB 0019, reviewed 2026-03-13)

Cardiac Event Monitors (CPB 0073, reviewed 2026-04-07)

Intensive Cardiac Rehabilitation Programs (CPB 0267, reviewed 2026-05-14)

Percutaneous Transluminal Septal Myocardial Ablation (PTSMA) (CPB 0558, reviewed 2026-02-19)

06.02.31g, Genetic Testing for Congenital Long QT Syndrome (Independence Administrators)

06.02.31g, Genetic Testing for Congenital Long QT Syndrome (Independence Administrators)

What insurance policy changes affect code R00.2?

Which payers have updated policy for code R00.2?

How do I get notified when code R00.2 policy changes?

Why do payers change policies for code R00.2?