CommercialCoverageMedium impact
Indirect Measurement of Left Ventricular Filling Pressure (LVFP) (CPB 0704, reviewed 2025-11-24)
Aetna·Cardiology, Internal Medicine, Critical Care·Medical Policy
Effective date
Nov 24, 2025
We identified it
Aug 18, 2026
Summary
Aetna has designated indirect measurement of left ventricular filling pressure (LVFP) procedures as experimental, investigational, or unproven, making them non-covered services effective immediately. This includes the VeriCor System (Valsalva maneuver-based arterial waveform analysis) and EchoGo Heart Failure AI software. Billing teams must deny claims for CPT 0932T and HCPCS C9786 when submitted for covered indications, and communicate non-coverage to providers and patients.
Action Required
Effective immediately (2025-11-24): Billing team must update claims processing system to deny CPT 0932T (noninvasive detection of heart failure with preserved ejection fraction) and HCPCS C9786 (EchoGo Heart Failure image post-processing) for all indications listed in CPB 0704. Update denial reason to reference experimental/investigational status per Aetna policy 0704. Cardiology and internal medicine providers must be notified via bulletin or EMR alert that these procedures are non-covered and will result in claim denials. Front desk and authorization staff should not issue prior authorizations for these codes. Claims submitted with ICD-10 codes I50.1-I50.9 (heart failure) paired with these CPT/HCPCS codes should trigger automatic denials with patient notification of non-coverage. Update patient education materials to reflect non-covered status. Failure to process denials correctly may result in improper reimbursement and compliance issues.