What insurance policy changes affect code R61?

There are 2 tracked policy changes affecting code R61, including updates from 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 R61?

Payers that have issued tracked updates for code R61 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code R61 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code R61. 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 R61?

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

R61 Insurance Policy Changes

ICD-10 R61 is officially defined as "Generalized hyperhidrosis." code R61 is referenced in 2 tracked payer policy changes from Aetna and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code R61 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.

Aetna · Identified Aug 18, 2026Medium impact
Iontophoresis (CPB 0229, reviewed 2026-04-23)
Aetna considers iontophoresis medically necessary for delivering local anesthetic before emergent skin puncture or dermatological procedures, for intractable disabling primary focal hyperhidrosis of the axillae, palms or soles when the stated criteria are met, for short-term iontophoretic fentanyl for acute postoperative pain, and for the sweat test by pilocarpine iontophoresis to diagnose cystic fibrosis. The policy lists many other uses as experimental, investigational or unproven, including acetic acid for rotator cuff disease, heel pain and epicondylitis, corticosteroid or NSAID iontophoresis for musculoskeletal disorders, onychomycosis and tinnitus, because of insufficient evidence of its effectiveness. CPT 97033 is covered for iontophoresis only when the selection criteria are met.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Estrogen Hormone Testing: Estradiol and Estrone
Measurement of estrogen hormones is considered medically necessary to evaluate ovarian function in females with symptoms of hypoestrogenism or hyperestrogenism, to diagnose hyperestrogenism in symptomatic males, to monitor hormone replacement therapy in postmenopausal females, and to monitor antiestrogen therapy. Measurement of estrogen hormones is considered not medically necessary when performed for screening purposes in asymptomatic patients. The covered tests are total estradiol (CPT 82670), fractionated estrogens (CPT 82671), total estrogens (CPT 82672), estrone (CPT 82679), and free estradiol by direct measurement, such as equilibrium dialysis (CPT 82681).

Watch R61

Get one email when a payer policy names R61, 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

Iontophoresis (CPB 0229, reviewed 2026-04-23)

Estrogen Hormone Testing: Estradiol and Estrone

What insurance policy changes affect code R61?

Which payers have updated policy for code R61?

How do I get notified when code R61 policy changes?

Why do payers change policies for code R61?