What insurance policy changes affect code R49.0?

There are 10 tracked policy changes affecting code R49.0, including updates from Independence Blue Cross, 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 R49.0?

Payers that have issued tracked updates for code R49.0 include: Independence Blue Cross, Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code R49.0 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code R49.0. 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 R49.0?

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.

PAYER POLICY CHANGES

R49.0 Insurance Policy Changes

ICD-10 R49.0 is officially defined as "Dysphonia." code R49.0 is referenced in 10 tracked payer policy changes from Independence Blue Cross, Aetna, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code R49.0 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Independence Blue Cross · Effective Oct 1, 2025Medium impact
MA07.050n, Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies
Independence Blue Cross MA07.050n policy for EMG/NCS studies was reissued with ICD-10 code updates effective 10/01/2025. Multiple sclerosis diagnosis code G35 was replaced with five new subcategory codes (G35.A, G35.B0, G35.B1, G35.B2, G35.C0, G35.C1, G35.C2, G35.D), and three S74.21X nerve injury codes had narrative corrections (high level changed to thigh level). No changes to covered procedures, CPT codes, or medical necessity criteria occurred.
Independence Blue Cross · Effective Sep 22, 2025Medium impact
MA07.050m, Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies
Independence Blue Cross Medicare Advantage policy MA07.050n (effective 09/22/2025) expands coverage for electrodiagnostic studies by removing two "Not Medically Necessary" restrictions: pattern-setting limited limb EMG for radiculopathies and portable hand-held/point-of-care nerve conduction devices. Additionally, psychophysical measurements are now designated as Not Medically Necessary, and Visual Evoked Potentials (VEP) and Brainstem Auditory Evoked Potentials (BAEP) have been added as medically necessary services.
Independence Blue Cross · Effective Sep 22, 2025Medium impact
07.03.09w, Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies
Independence Blue Cross updated policy 07.03.09w to 07.03.09x, expanding coverage for electrodiagnostic studies by removing prior restrictions on pattern-setting limited limb EMG for radiculopathies and portable/automated nerve conduction devices. New psychophysical measurement testing was added as not medically necessary, and Visual and Brainstem Auditory Evoked Potentials were explicitly added as covered services. Applicable CPT/HCPCS codes have been updated to align with these changes.
Aetna · Identified Oct 1, 2026Medium impact
Voice Therapy (CPB 0646, reviewed 2026-09-09)
Aetna considers voice therapy medically necessary to restore the ability to produce speech sounds from the larynx for essential voice tremor, surgery or traumatic injury to the vocal cords, treatment for laryngeal (glottic) carcinoma, muscle tension dysphonia, paradoxical vocal cord motion, post-laryngectomy esophageal speech production, spastic dysphonia, symptomatic benign vocal fold lesions, and vocal cord paralysis. Aetna considers voice therapy not medically necessary for improving voice quality, for occupational or recreational purposes, for self-limited conditions such as acute laryngitis, or as maintenance treatment where symptoms are not improving. Pre-operative voice therapy for benign vocal fold lesions and voice therapy for vocal fold motion impairment following chemotherapy are considered experimental, investigational, or unproven, and voice therapy to feminize or masculinize the voice for transgender individuals is considered not medically necessary and cosmetic.
Aetna · Identified Aug 14, 2026Medium impact
Voice Therapy (CPB 0646, reviewed 2025-12-08)
Aetna considers voice therapy medically necessary to restore the ability to produce speech sounds from the larynx for essential voice tremor, surgery or traumatic injury to the vocal cords, treatment for laryngeal (glottic) carcinoma, muscle tension dysphonia, paradoxical vocal cord motion, post-laryngectomy esophageal speech production, spastic dysphonia, symptomatic benign vocal fold lesions, and vocal cord paralysis. Voice therapy is not medically necessary to improve voice quality, for occupational or recreational purposes, or for self-limited conditions such as acute laryngitis, and maintenance treatment where symptoms are not improving is not medically necessary. Pre-operative voice therapy for improving outcomes of surgery for benign vocal fold lesions, and voice therapy for vocal fold motion impairment following chemotherapy, are considered experimental, investigational, or unproven.
Aetna · Identified Aug 14, 2026Medium impact
Pulsed Dye Laser Treatment (CPB 0559, reviewed 2025-08-22)
Pulsed dye laser treatment is medically necessary for actinic keratoses that failed to adequately respond to imiquimod, 5-FU, or cryosurgery, for capillary malformation with overgrowth or vascular malformation, for genital warts when home therapy with podophyllotoxin or imiquimod has failed, for granuloma faciale, for infantile hemangiomas, and for port wine stains and other hemangiomas on the face and neck. It is also medically necessary for keloids or hypertrophic scars from an injury or surgical procedure that cause significant pain requiring chronic analgesic medication or significant functional impairment, for multiple superficially located glomangiomas in the face and neck where surgical excision is not practical, for pyogenic granuloma in the face and neck, for symptomatic angiolymphoid hyperplasia that has failed medical therapy, and for verrucae after at least two conventional therapies have failed. Pulsed dye laser is considered experimental, investigational, or unproven for other conditions, including active acne, onychomycosis, hidradenitis suppurativa, molluscum contagiosum, and morphea, and cosmetic for conditions including rosacea, facial redness, solar lentigines, and striae distensae.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
State and School Employees' Health Insurance Plan - Botulinum Toxin
Botox (onabotulinumtoxinA) is the only covered botulinum toxin preparation for non-cosmetic indications under this policy. Dysport, Myobloc and Xeomin are considered not medically necessary because a formulary alternative is available. Botox may be considered medically necessary for overactive bladder, detrusor overactivity associated with a neurologic condition, chronic migraine prophylaxis, spasticity, cervical dystonia, primary axillary hyperhidrosis, blepharospasm, strabismus and spasmodic dysphonia when all criteria for the indication are met. Each indication has a 12-month length of approval and a maximum dose per 12 weeks. Revised criteria for detrusor overactivity, migraine prophylaxis and blepharospasm were approved by the Pharmacy and Therapeutics Committee on 05/26/2026.
Independence Blue Cross · Effective Oct 1, 2025Low impact
MA07.050n, Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies
Independence Blue Cross updated ICD-10 diagnosis codes for MA07.050n (EMG/NCS policy) effective 10/01/2025. Multiple sclerosis code G35 was replaced with more specific codes (G35.A, G35.B0-B2, G35.C0-C2, G35.D), and three S74.21 nerve injury codes were corrected from 'hip and high level' to 'hip and thigh level'. No changes to covered procedures, CPT codes, or medical necessity criteria. This is a routine annual code update with no billing workflow impact.
Independence Blue Cross · Effective Oct 1, 2025Low impact
07.03.09x, Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies
Independence Blue Cross reissued Policy 07.03.09x for EMG/NCS studies with ICD-10 code updates effective 10/01/2025. Multiple sclerosis diagnosis codes were expanded from a single code (G35) to five specific subcategories (G35.A, G35.B0, G35.B1, G35.B2, G35.C0, G35.C1, G35.C2, G35.D), and three S74.21X nerve injury codes had narrative corrections from 'hip and high level' to 'hip and thigh level'. No changes to covered procedures, medical necessity criteria, or billing codes.
Independence Blue Cross · Effective Oct 1, 2025Low impact
07.03.09x, Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies
Independence Blue Cross reissued policy 07.03.09x on EMG/NCS studies with ICD-10 code updates effective 10/01/2025. Multiple sclerosis diagnosis codes were granularized (G35 replaced with G35.A, G35.B0-B2, G35.C0-C2, G35.D), and three S74.21 nerve injury codes were corrected from 'hip and high level' to 'hip and thigh level'. No changes to covered procedures, CPT codes, or medical necessity criteria.

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MA07.050n, Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies

MA07.050m, Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies

07.03.09w, Electromyography (EMG) Studies, Nerve Conduction Studies (NCS), and Related Electrodiagnostic Studies

Voice Therapy (CPB 0646, reviewed 2026-09-09)

Voice Therapy (CPB 0646, reviewed 2025-12-08)

Pulsed Dye Laser Treatment (CPB 0559, reviewed 2025-08-22)

State and School Employees' Health Insurance Plan - Botulinum Toxin