CommercialCoverageMedium impact
07.02.21r, Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring
Independence Blue Cross·PA · Cardiology, Internal Medicine, Family Medicine +1 more·Medical Policy
Effective date
Jul 21, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated AECG/MCOT monitoring policy (07.02.21s, effective 07/21/2025) to expand medically necessary continuous monitoring from 48 hours up to 15 days, and explicitly classify monitoring beyond 15 days as experimental/investigational and not covered. One ICD-10 code (Z09) was removed from covered diagnoses.
Action Required
By July 21, 2025: (1) Billing team must update system edits to allow continuous AECG/MCOT monitoring for up to 15 days as medically necessary; configure system to deny or flag as experimental/investigational any claims requesting monitoring beyond 15 days. (2) Remove ICD-10 code Z09 from the list of covered diagnoses for AECG/MCOT procedures in billing software and encounter forms. (3) Providers must document in clinical notes the total anticipated monitoring duration and ensure it does not exceed 15 days for covered services. (4) Update internal policy documentation and staff training materials to reflect the 15-day coverage limit. Claims submitted for AECG/MCOT monitoring beyond 15 days will be denied as experimental/investigational.