Medium impact
Sialolithiasis (Salivary Stones) (CPB 0716, reviewed 2025-10-14)
Aetna·Effective Oct 14, 2025
Aetna updated its sialolithiasis (salivary stone) policy to clarify covered and non-covered procedures. Sialendoscopy, extracorporeal shock wave lithotripsy, intraductal laser lithotripsy, and diagnostic imaging (ultrasound and CT) are now explicitly covered when criteria are met. However, multiple emerging treatments (pneumatic lithotripsy, sialodochoplasty, elastography, augmented reality visualization, alpha-blockers, and others) are classified as experimental/investigational and not covered. Importantly, sialendoscopy performed with other salivary gland surgery is now considered inclusive and will not be reimbursed separately.