31622 Insurance Policy Changes

Lung Denervation Therapy and Lung Volume Reduction Surgery (CPB 0160, reviewed 2026-03-26)

Aetna updated its coverage policy for lung denervation therapy and lung volume reduction surgery (CPB 0160), effective 2026-03-26. The policy clarifies medical necessity criteria for LVRS, bullectomy, and FDA-approved endobronchial valves, while designating targeted lung denervation (dNerva system), bronchoscopic thermal vapor ablation, biologic lung volume reduction, and thoracoscopic laser bullectomy as experimental/investigational and not covered. Billing teams must immediately verify that claims for these procedures include proper prior authorization and meet the detailed selection criteria outlined in the policy.