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AetnaAll Plans · Coverage · Medical Policy · Cardiology, NeurologyMedium impact

Cardiac Event Monitors (CPB 0073, reviewed 2026-04-07)

Effective date
Not stated in the notice
Identified
Aug 15, 2026
Replaced. This version was replaced by Cardiac Event Monitors (CPB 0073, reviewed 2026-10-26) (published Oct 26, 2026).

Summary

Aetna considers external intermittent cardiac event monitors, external ECG monitoring for greater than 48 hours by continuous rhythm recording (such as the Zio Patch), mobile cardiovascular telemetry, and implantable loop recorders medically necessary when the listed criteria are met. The criteria cover syncope, lightheadedness, presyncope, palpitations and dizziness, and suspected atrial fibrillation as a cause of cryptogenic stroke, in members with a non-diagnostic Holter monitor or 48 hour telemetry or with symptoms that occur less often than daily. Aetna considers these monitors experimental, investigational, or unproven for all other indications, and it lists several handheld and self-monitoring ECG devices, including Kardia Mobile, Kardia 12L, KardiaMobile 6L, BodyGuardian, iHEART and the ViSi Mobile Monitoring System, as experimental, investigational, or unproven.

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What to do

Action · 10 steps
01REQUIREMENTS: Billing team: Before billing an external monitor, mobile cardiovascular telemetry, or implantable loop recorder, confirm the documented indication is one the policy lists, because Aetna considers these devices experimental, investigational, or unproven for other indications.
02For syncope, lightheadedness, presyncope, palpitations or dizziness monitored with external intermittent monitors or long-term external ECG monitoring, document a non-diagnostic Holter monitor or 48 hour telemetry, or symptoms that occur less frequently than daily so that the arrhythmia is unlikely to be diagnosed by Holter monitoring.
03For mobile cardiovascular telemetry used for suspected atrial fibrillation as a cause of cryptogenic stroke, document a non-diagnostic Holter monitor or 48 hour telemetry.
04For an implantable loop recorder used for that indication, document a non-diagnostic 30-day external mobile cardiovascular telemetry with electrocardiographic recording.
05For an implantable loop recorder used for atrial fibrillation surveillance, document a HATCH score of at least 2 and no history of atrial fibrillation.
06CPT 93040 (AliveCor Heart Monitor) and CPT 0902T through 0905T (Kardia 12L and Kardia Mobile 6L) are listed as not covered for the indications listed in the policy.
07Requests that do not meet the medical necessity criteria, and requests for repeat studies within 1 year of a previous study, are subject to medical necessity review.
08Reimplantation of an implantable loop recorder must meet a new indication from the list.
09If a loop recorder was implanted for cryptogenic stroke and showed no significant arrhythmia during its full lifespan, another loop recorder for workup of the same event is not considered medically necessary.
10Removal of an end-of-life implantable loop recorder is considered medically necessary and can be approved.

Codes mentioned

93268932709327193272936539322893229332853328693285932919329893224932259322693227932419324293243932449324593246932479324893040C1764E0616I44.0I45.9I47.0I49.9I63.00I63.9I66.9R00.0R00.1R00.2R42R55R56.9Z86.73G45.0G45.3G45.8G45.9

Original notice

Cardiac Event Monitors (CPB 0073, reviewed 2026-04-07)
aetna.com · Always check the source before changing claims.
View original ↗

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Related policy hubs

Aetna policiesCardiologyNeurologyCode 93268Code 93270Code 93271Code 93272Code 93653Code 93228Code 93229Code 33285Code 33286Code 93285Code 93291Code 93298Code 93224Code 93225Code 93226Code 93227Code 93241Code 93242Code 93243Code 93244Code 93245Code 93246Code 93247Code 93248Code 93040Code C1764Code E0616Code I44.0Code I45.9Code I47.0Code I49.9Code I63.00Code I63.9Code I66.9Code R00.0Code R00.1Code R00.2Code R42Code R55Code R56.9Code Z86.73Code G45.0Code G45.3Code G45.8Code G45.9

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