What insurance policy changes affect code R06.3?

There are 2 tracked policy changes affecting code R06.3, including updates from Excellus BlueCross BlueShield, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code R06.3?

Payers that have issued tracked updates for code R06.3 include: Excellus BlueCross BlueShield, Aetna.

How do I get notified when code R06.3 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code R06.3. 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 R06.3?

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

R06.3 Insurance Policy Changes

ICD-10 R06.3 is officially defined as "Periodic breathing." code R06.3 is referenced in 2 tracked payer policy changes from Excellus BlueCross BlueShield and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code R06.3 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.

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 Nov 3, 2026Medium impact
Computerized Wheeze Detectors (CPB 0813, reviewed 2026-10-28)
Aetna's Clinical Policy Bulletin 0813 (reviewed 2026-10-28) classifies computerized wheeze detectors—including the PulmoTrack, Personal Wheezometer, and VRIxp devices—as experimental, investigational, or unproven for diagnostic evaluation of lung sounds, cough, and all other indications due to insufficient evidence of effectiveness. Claims for these devices will be denied for Aetna members.

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Cardiac Event Monitors 2.01.03

Computerized Wheeze Detectors (CPB 0813, reviewed 2026-10-28)

What insurance policy changes affect code R06.3?

Which payers have updated policy for code R06.3?

How do I get notified when code R06.3 policy changes?

Why do payers change policies for code R06.3?