Medicare AdvantageBilling CodesMedium impact
MA05.005h, Automatic External Cardioverter Defibrillators (Wearable and Nonwearable)
Independence Blue Cross·Cardiology, Critical Care, Internal Medicine·Medical Policy
Effective date
Oct 1, 2026
We identified it
Oct 2, 2026
Summary
Independence Blue Cross updated MA05.005h to refine ICD-10 diagnosis codes for wearable and nonwearable automatic external defibrillators (AEDs) effective 10/01/2026. Six new cardiomyopathy and arrhythmia codes were added (I42.00, I42.09, I42.81, I42.89, I47.22, I42.01) while two non-specific codes were deleted (I42.0, I42.8). This is a coding precision update; coverage criteria and HCPCS billing codes remain unchanged. Billing teams must update diagnosis code mapping to ensure claims are submitted with the new specific codes rather than the deleted non-specific codes.
Action Required
By 09/15/2026: Billing team must update diagnosis code mapping in the billing system to remove deprecated codes I42.0 and I42.8 from AED claim submissions. Add the six new specific ICD-10 codes (I42.00, I42.09, I42.81, I42.89, I47.22, I42.01) to the system's valid diagnosis code list for wearable and nonwearable AED claims (HCPCS K0606 and E0617). Update clinical documentation templates and provider guidelines to require use of specific cardiomyopathy and arrhythmia diagnoses. Test all claim submissions with the new codes before 10/01/2026 effective date. Claims submitted with deleted codes I42.0 or I42.8 on or after 10/01/2026 will be subject to denial or recoding by Independence Blue Cross.