U09.9 Insurance Policy Changes

ICD-10 U09.9 is officially defined as "Post COVID-19 condition, unspecified." code U09.9 is referenced in 14 tracked payer policy changes from Aetna and Colorado Medicaid. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code U09.9 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Oct 10, 2026Medium impact
Constraint-Induced Therapy (CPB 0665, reviewed 2026-10-08)
Aetna considers constraint-induced movement therapy (CIMT) medically necessary for upper limb hemiparesis in persons with stroke who have at least 10 degrees of active wrist and finger extension and no sensory or cognitive deficits, and for upper limb hemiparesis in hemiplegic cerebral palsy. Coverage is for a 4-week CIMT program that can be extended by another 4 weeks when documentation shows improvement of functions. CIMT for lower limb hemiparesis, brachial plexus palsy, multiple sclerosis, Parkinson's disease, spinal cord injury, traumatic brain injury and hemiplegia from brain tumors, along with several CIMT combinations and related therapies, are considered experimental, investigational or unproven.
Aetna · Identified Aug 19, 2026Medium impact
Compression Garments for the Legs (CPB 0482, reviewed 2026-07-29)
Aetna considers inflatable compression garments, non-elastic binders and pre-made medical grade (greater than 18 mm Hg) compression stockings medically necessary for listed conditions, including complications of chronic venous insufficiency, lymphedema, post-thrombotic syndrome, edema following surgery, fracture, burns or other trauma, and prevention of thrombosis in immobilized persons. Individually fitted (custom-made) medical grade stockings are medically necessary only for members who have tried and failed a 3-month trial of pre-made medical grade stockings, except for members with venous ulcers or lymphedema. Silver impregnated compression stockings are considered not medically necessary, and compression garments for the legs are considered experimental, investigational or unproven for listed indications such as Parkinson disease, delayed-onset muscle soreness and Long COVID autonomic dysfunction.
Aetna · Identified Aug 18, 2026Medium impact
Nerve Blocks (CPB 0863, reviewed 2026-07-23)
Aetna Clinical Policy Bulletin 0863 covers nerve blocks and lists which ones it considers medically necessary. Covered uses include adductor canal, femoral, fascia iliaca, erector spinae plane and transversus abdominis plane blocks for post-operative pain after specific surgeries, and celiac plexus block for cancer pain, while peripheral nerve blocks for chronic pain are covered only as an active component of a comprehensive pain management program. Blocks listed as experimental and investigational include genicular nerve blocks and peripheral nerve blocks used as the sole treatment for chronic non-malignant pain, because the effectiveness of these approaches has not been established.
Aetna · Identified Aug 15, 2026Medium impact
Respiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (CPB 0479, reviewed 2026-07-09)
Aetna's Clinical Policy Bulletin 0479 covers incentive spirometers, vaporizers and intermittent positive pressure breathing (IPPB) machines. Aetna considers incentive spirometers medically necessary as durable medical equipment for post-operative use in members with neuromuscular or chest wall diseases, and IPPB machines medically necessary as durable medical equipment for members with asthma, COPD and other respiratory diseases. Aetna does not cover vaporizers because they are not considered primarily medical in nature, and it considers the SpiroTimer and incentive spirometry or IPPB for all other listed indications experimental, investigational, or unproven.
Aetna · Identified Aug 15, 2026Medium impact
Fecal Bacteriotherapy (CPB 0844, reviewed 2026-03-25)
Aetna's commercial clinical policy bulletin 0844 covers fecal bacteriotherapy. It considers fecal microbiota transplant medically necessary for Clostridium difficile infection (CDI) confirmed by a positive C. difficile toxin stool test that has recurred after at least one course of adequate antibiotic therapy. It considers a single rectal dose of Rebyota (fecal microbiota, live-jslm) medically necessary for preventing CDI when the policy's criteria are met, and it considers other listed indications, including alcoholic hepatitis, Crohn's disease, ulcerative colitis and irritable bowel syndrome, experimental, investigational, or unproven.
Aetna · Identified Aug 15, 2026Medium impact
Complementary and Alternative Medicine (CPB 0388, reviewed 2026-06-25)
Aetna covers alternative medicine interventions when they are supported by adequate evidence of safety and effectiveness in the peer-reviewed published medical literature, subject to benefit plan limitations and exclusions. Acupuncture, biofeedback, chelation therapy, chiropractic services and electrical stimulation are addressed under separate Aetna policies. Many other interventions are listed as experimental, investigational or unproven, including intravenous micronutrient therapy (Myers' Cocktail), Gua Sha, colon hydrotherapy and the Patricia Kane protocol, and standard benefit plans exclude nutritional supplements and medical marijuana.
Aetna · Identified Aug 15, 2026Medium impact
Constraint-Induced Therapy (CPB 0665, reviewed 2025-10-07)
Aetna considers constraint-induced movement therapy (CIMT) medically necessary for upper limb hemiparesis in persons with stroke who have at least 10 degrees of active wrist and finger extension and no sensory and cognitive deficits, and for upper limb hemiparesis in hemiplegic cerebral palsy. Coverage is for a 4-week CIMT program that can be extended for another 4 weeks if there is documentation of improvement of functions. CIMT for brachial plexus palsy, hemiplegia from brain tumors, lower limb hemiparesis in stroke, multiple sclerosis, Parkinson's disease, spinal cord injury and traumatic brain injury, and CIMT combined with peripheral nerve stimulation, transcranial stimulation, biofeedback or electroacupuncture, are considered experimental, investigational or unproven.
Aetna · Identified Aug 15, 2026Medium impact
Cardiopulmonary Exercise Testing (CPB 0825, reviewed 2025-12-03)
Aetna considers cardiopulmonary exercise testing (CPET, CPT 94621) medically necessary for listed conditions after standard testing, including echocardiography, pulmonary function testing with diffusion capacity, and oxygen desaturation measured on the 6-minute walk test. The listed conditions include post-operative evaluation of chronic thromboembolic pulmonary hypertension after pulmonary thromboendarterectomy, developing exercise prescriptions for cardiac or pulmonary rehabilitation, evaluating exercise capacity and response to therapy in chronic heart failure patients considered for heart transplantation or other advanced therapies, and evaluating post-acute sequelae of COVID-19 (Long COVID). CPET is considered experimental, investigational or unproven as a screening exercise test, as a routine pre-operative assessment, and as a first-line diagnostic test for possible cardiac or pulmonary pathology.
Aetna · Identified Aug 14, 2026Medium impact
Cognitive Rehabilitation (CPB 0214, reviewed 2026-04-21)
Aetna considers cognitive rehabilitation medically necessary as adjunctive treatment of cognitive deficits when it is performed by a licensed health care professional within their scope of practice and all of the following are met: neuropsychological testing has been performed and its results will be used in treatment planning and directing rehabilitation strategies; the cognitive deficits were acquired from moderate to severe traumatic brain injury, brain surgery, stroke, or encephalopathy; a psychiatric evaluation by a licensed mental health provider has been received when there is a behavioral health concern or possible comorbid condition; the member can actively participate in a program (not comatose or in a vegetative state); and the member is expected to make significant cognitive improvement. Cognitive rehabilitation is considered experimental, investigational or unproven for indications including mild traumatic brain injury (including sports-related concussion), dementia, long COVID, multiple sclerosis, ADHD, autism spectrum disorders, coma stimulation, and virtual reality therapy for acquired cognitive disorders. Outpatient cognitive rehabilitation coverage is subject to applicable benefit plan terms and limitations for physical and occupational therapy.
Aetna · Identified Aug 14, 2026Medium impact
Smell and Taste Disorders: Diagnosis (CPB 0390, reviewed 2026-05-26)
Aetna's Clinical Policy Bulletin 0390 sets the coverage rules for diagnosing smell and taste disorders. Aetna considers the following medically necessary for members with unexplained olfactory dysfunction or gustatory dysfunction: biopsy of the olfactory mucosa, drug assays and chemical analyses, electroencephalography for members with a history of seizures, hematological tests, medical evaluation, nasal endoscopy, CT or MRI to rule out an intracranial or peripheral nerve abnormality, neurological, otolaryngological and psychiatric consultation, standard taste tests, and standardized olfactory tests such as the University of Pennsylvania Smell Identification Test or Sniffin' Sticks. An initial visit and a follow-up visit are considered medically necessary for smell and taste testing, and additional visits for testing are considered not medically necessary. Aetna considers cerebrospinal fluid SARS-CoV-2 antibody testing, electrogustometry, TAS2R38 gene genotyping, MRI for COVID-19 olfactory dysfunction, nasal nitric oxide measurement, olfactometry, olfactory and gustatory event potentials, PET, rhinomanometry, rhinometry, SPECT, and H. pylori tests experimental, investigational or unproven for diagnosing these disorders.
Aetna · Identified Aug 14, 2026Medium impact
Pulmonary Rehabilitation (CPB 0032, reviewed 2026-03-05)
Aetna considers entry into a medically supervised outpatient pulmonary rehabilitation program medically necessary when the member has a chronic pulmonary disease or another condition that affects pulmonary function, dyspnea at rest or with exertion, reduced exercise tolerance that restricts activities of daily living or work, symptoms that persist despite appropriate medical management, and a moderate to severe functional pulmonary disability. That disability is shown either by a maximal exercise stress test with VO2max of 20 ml/kg/min or less (about 5 METS) or by FEV1, FVC, FEV1/FVC, or DLCO below 60 % of predicted, and the member must be physically able, motivated, and willing to participate. A typical course extends for up to 6 weeks or 36 hours of therapy. Repeat programs are considered not medically necessary, except in connection with lung transplantation or lung volume reduction surgery, and routine, maintenance, or non-skilled care is considered not medically necessary. Pulmonary rehabilitation is considered experimental, investigational, or unproven for all other indications.
Aetna · Identified Aug 12, 2026Medium impact
Crizanlizumab-tmca (Adakveo) (CPB 0964, reviewed 2025-12-09)
Aetna considers Adakveo (crizanlizumab-tmca) medically necessary for reducing the frequency of vaso-occlusive crises in members 16 years of age or older with sickle cell disease, when the member has had at least one vaso-occlusive crisis in the previous 12 months and either has HbSC, HbSβ+, or another genotypic variant of sickle cell disease, or has HbSS or HbSβ0 genotype and has had an inadequate response to, an intolerance of, or a contraindication to hydroxyurea, or will use Adakveo with concurrent hydroxyurea. Continuation is considered medically necessary when the frequency of vaso-occlusive crises has been reduced since starting therapy or has stayed reduced, and Adakveo must be prescribed by or in consultation with a hematologist or sickle cell disease specialist. All other indications are considered experimental, investigational, or unproven, including treatment and prevention of adverse outcomes in COVID-19. This policy covers commercial medical plans, and Medicare criteria are in Medicare Part B Criteria.
Aetna · Identified Aug 12, 2026Medium impact
Autonomic Testing / Sudomotor Tests (CPB 0485, reviewed 2026-08-11)
Aetna considers autonomic testing, including quantitative sudomotor axon reflex test (QSART), silastic sweat imprint, and thermoregulatory sweat test (TST), medically necessary as a diagnostic tool for amyloid neuropathy, autoimmune autonomic ganglionopathy, diabetic autonomic neuropathy, distal small fiber neuropathy, idiopathic neuropathy, long-COVID syndrome with suspected autonomic disorder, multiple system atrophy, orthostatic hypotension, Parkinson disease, postural tachycardia syndrome, pure autonomic failure, recurrent unexplained syncope, reflex sympathetic dystrophy or causalgia, and Sjogren's syndrome. Aetna considers autonomic testing experimental, investigational, or unproven for other indications, including chronic fatigue syndrome/myalgic encephalomyelitis, concussion, predicting foot ulcers, Raynaud phenomenon, traumatic brachial plexus injury, and traumatic brain injury. Sympathetic skin response testing, EZSCAN, SudoScan, QDIRT, QPART, VitalScan Systems, and automated devices that generate their own software interpretation are considered experimental, investigational, or unproven for the uses listed in the policy.
Colorado Medicaid · Identified Jun 20, 2026Medium impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2200475 - 02/2022)
The February 2022 Health First Colorado provider bulletin (B2200475) covers several changes. Effective February 1, 2022, claims requiring electronic visit verification (EVV) go through pre-payment review, and claims without the needed EVV records may deny with EOB 3054. The bulletin also describes at-home OTC COVID-19 test billing under HCPCS E1399 with modifier U1 from January 15, 2022, requires the ordering provider's NPI on DMEPOS claims effective July 1, 2022, and notes that 24 physician-administered drug codes became subject to prior authorization effective January 18, 2022.

Watch U09.9

Get one email when a payer policy names U09.9, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

No account needed. We send a confirmation link first, and every email has a one-click stop link.

FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code U09.9?

There are 14 tracked policy changes affecting code U09.9, including updates from Aetna, Colorado Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code U09.9?

Payers that have issued tracked updates for code U09.9 include: Aetna, Colorado Medicaid.

How do I get notified when code U09.9 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code U09.9. 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 U09.9?

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

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

Constraint-Induced Therapy (CPB 0665, reviewed 2026-10-08)

Compression Garments for the Legs (CPB 0482, reviewed 2026-07-29)

Nerve Blocks (CPB 0863, reviewed 2026-07-23)

Respiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (CPB 0479, reviewed 2026-07-09)

Fecal Bacteriotherapy (CPB 0844, reviewed 2026-03-25)

Complementary and Alternative Medicine (CPB 0388, reviewed 2026-06-25)

Constraint-Induced Therapy (CPB 0665, reviewed 2025-10-07)

Cardiopulmonary Exercise Testing (CPB 0825, reviewed 2025-12-03)

Cognitive Rehabilitation (CPB 0214, reviewed 2026-04-21)

Smell and Taste Disorders: Diagnosis (CPB 0390, reviewed 2026-05-26)

Pulmonary Rehabilitation (CPB 0032, reviewed 2026-03-05)

Crizanlizumab-tmca (Adakveo) (CPB 0964, reviewed 2025-12-09)

Autonomic Testing / Sudomotor Tests (CPB 0485, reviewed 2026-08-11)

Health First Colorado (Colorado's Medicaid Program) News and Updates (B2200475 - 02/2022)

What insurance policy changes affect code U09.9?

Which payers have updated policy for code U09.9?

How do I get notified when code U09.9 policy changes?

Why do payers change policies for code U09.9?