Medium impact
Intermittent Intravenous Insulin Therapy (CPB 0742, reviewed 2025-11-26)
Aetna·Effective Nov 26, 2025
HCPCS J1813 is officially defined as "Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units." HCPCS J1813 is referenced in 1 tracked payer policy change from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS J1813 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
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