What insurance policy changes affect code Z87.798?

There are 2 tracked policy changes affecting code Z87.798, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code Z87.798?

Payers that have issued tracked updates for code Z87.798 include: Aetna.

How do I get notified when code Z87.798 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code Z87.798. 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 Z87.798?

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

Z87.798 Insurance Policy Changes

ICD-10 Z87.798 is officially defined as "Personal history of other (corrected) congenital malformations." code Z87.798 is referenced in 2 tracked payer policy changes from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code Z87.798 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 17, 2026Medium impact
Genetic Counseling (CPB 0189, reviewed 2026-03-27)
Aetna considers genetic counseling medically necessary for listed pregnancy-related indications, including couples who are closely related genetically, familial cancer disorders, pregnant women with maternal age 35 years or greater at delivery, and parents of a child born with a genetic disorder or birth defect. Genetic counseling unrelated to pregnancy is covered when it is appropriate for, or provided with, medically necessary genetic testing in accordance with ACMG guidelines. Genetic counseling for all other indications is considered experimental, investigational or unproven.
Aetna · Identified Aug 16, 2026Medium impact
RET Proto-Oncogene Testing (CPB 0319, reviewed 2026-06-08)
Aetna considers germline RET proto-oncogene testing medically necessary for members with a personal history of medullary thyroid carcinoma (familial or apparently sporadic), pheochromocytoma or paraganglioma when multiple endocrine neoplasia type 2 (MEN2) is suspected, parathyroid adenoma or hyperplasia when MEN2A is suspected, C-cell hyperplasia on pathology, or clinical features of MEN2B. Family history criteria include a first-degree blood relative with medullary thyroid carcinoma, a first-degree or second-degree blood relative with a known germline RET pathogenic variant, and a family pattern consistent with familial medullary thyroid carcinoma. Germline RET testing for all other indications, such as non-small cell lung cancer, is considered experimental, investigational, or unproven.

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Genetic Counseling (CPB 0189, reviewed 2026-03-27)

RET Proto-Oncogene Testing (CPB 0319, reviewed 2026-06-08)

What insurance policy changes affect code Z87.798?

Which payers have updated policy for code Z87.798?

How do I get notified when code Z87.798 policy changes?

Why do payers change policies for code Z87.798?