CommercialCoverageMedium impact
Rebreathing of Inert Gas for Measurement of Cardiac Output and Validation of Intra-Cardiac Shunt (CPB 0714, reviewed 2025-11-25)
Aetna·Cardiology, Critical Care, Pulmonology·Medical Policy
Effective date
Nov 25, 2025
We identified it
Aug 15, 2026
Summary
Aetna classifies rebreathing of inert gas for cardiac output measurement, pulmonary hypertension survival prediction, and intra-cardiac shunt validation as experimental, investigational, or unproven. This policy designates these procedures as non-covered services, meaning claims for these specific applications will be denied. Billing teams must identify claims using these techniques and ensure they are not submitted for reimbursement under Aetna plans.
Action Required
By December 9, 2025: Billing and clinical teams must identify any current or planned procedures using rebreathing of inert gas for: (1) cardiac output measurement, (2) pulmonary hypertension survival prediction, or (3) intra-cardiac shunt validation. For Aetna members, these procedures must not be billed as they are classified as experimental/investigational. Update billing system denial rules to flag these procedures when associated with Aetna plans. Communicate with cardiology and pulmonology providers that these techniques are not reimbursable under Aetna coverage. If providers currently use this technology, obtain alternative methods for cardiac output assessment (thermodilution, Doppler echocardiography, or electrical bioimpedance per CPB 0472). Failure to comply will result in claim denials and potential overpayment recovery demands from Aetna.