CommercialBilling CodesMedium impact
05.00.29p, Automatic External Cardioverter Defibrillators (Wearable and Nonwearable)
Independence Blue Cross·Cardiology, Critical Care, Emergency Medicine +1 more·Medical Policy
Effective date
Oct 1, 2026
We identified it
Oct 2, 2026
Summary
Independence Blue Cross updated policy 05.00.29p with refined ICD-10 diagnosis codes for wearable and nonwearable automatic external defibrillators (AEDs), effective 10/01/2026. Six new cardiomyopathy and arrhythmia codes (I42.00, I42.09, I42.81, I42.89, I47.22, I42.01) were added to Attachment A, while two broad codes (I42.0, I42.8) were deleted. Billing teams must update diagnosis code validation to reflect these specific codes for AED coverage determinations.
Action Required
By 10/01/2026: Billing team must update diagnosis code validation logic in the billing system to replace deleted codes (I42.0, I42.8) with the six new specific cardiomyopathy and arrhythmia codes (I42.00, I42.09, I42.81, I42.89, I47.22, I42.01) in Attachment A. Update claim scrubbing rules to accept only the new specific codes for AED coverage determination when billing HCPCS codes K0606, E0617, and associated CPT codes 93292 and 93745. Notify providers that claims submitted with the deleted broad codes I42.0 or I42.8 will be denied or require code correction. Before 09/30/2026, test billing system updates in staging environment to ensure proper code mapping and no disruption to AED claim processing at the effective date.