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CommercialCoverageMedium impact

Body Surface Potential Mapping (CPB 0705, reviewed 2025-11-24)

Aetna·Cardiology, Cardiothoracic Surgery, Critical Care·Medical Policy
Effective date
Nov 24, 2025
We identified it
Aug 12, 2026
Days to comply

Summary

Aetna has classified Body Surface Potential Mapping (BSPM) as experimental, investigational, or unproven for five cardiac indications including acute coronary syndromes, atrial fibrillation, Brugada syndrome, atrial fibrillation ablation guidance, and cardiac resynchronization therapy response prediction. CPT codes 0695T and 0696T are not covered for these specified indications. This policy became effective November 24, 2025.

Action Required

Action needed
Effective immediately (November 24, 2025): Billing team must deny or request medical necessity review for claims containing CPT 0695T or 0696T when used for the five non-covered indications: acute coronary syndromes, atrial fibrillation, Brugada syndrome, atrial fibrillation ablation guidance, or cardiac resynchronization therapy response prediction. Update billing system edits to flag these codes for Aetna claims and route to prior authorization or denial protocols. Providers must be notified that these procedures require prior authorization or alternative documentation of medical necessity for coverage consideration. Related cardiac device/ablation codes (33208-33264, 93000-93657, C7537-C7540) remain billable when used independently; however, when combined with BSPM mapping procedures for the specified indications, the mapping component will not be reimbursed. Claims submitted without prior authorization may be denied. Front-desk and authorization teams should cross-reference this policy when scheduling cardiac electrophysiology procedures.

Affected Billing Codes

33208
33214
33224
33225
33229
33249
33263
33264
93000
93278
93281
93282
93283
93284
93288
93289
93294
93295
93296
93297
93641
93653
93654
93655
93656
93657
C7537
C7538
C7539
C7540