CommercialCoverageHigh impact
Signal-Averaged Electrocardiography (SAECG) and Artificial Intelligence Algorithmic Electrocardiogram (CPB 0664, reviewed 2025-12-08)
Aetna·Cardiology, Internal Medicine, Critical Care +1 more·Medical Policy
Effective date
Dec 8, 2025
We identified it
Aug 16, 2026
Summary
Aetna has classified Signal-Averaged Electrocardiography (SAECG), artificial intelligence-based algorithmic ECG assessment, remote algorithmic analysis of ECG-derived data, and vMap arrhythmia analysis as experimental, investigational, or unproven. These services are NOT covered under Aetna plans. Billing teams must deny claims or obtain explicit prior authorization clarification before processing.
Action Required
Immediately effective December 8, 2025: Billing team must update claims processing system to DENY or flag for manual review all claims containing CPT codes 93278, 0764T, 0765T, and 0897T when submitted to Aetna. Providers must be notified that these codes are considered experimental/investigational and require explicit prior authorization documentation demonstrating medical necessity before claims will be processed. Update billing software editing rules to require medical necessity justification for these four codes. Route any claims for these procedures through prior authorization workflow before submission. Failure to follow this guidance will result in claim denials and patient balance issues. Compliance must be completed by December 15, 2025.