44369 Insurance Policy Changes

Radiofrequency Tumor Ablation (CPB 0492, reviewed 2026-07-29)

Aetna updated its Radiofrequency Tumor Ablation policy (CPB 0492) effective 2026-07-29, clarifying covered and non-covered indications. The policy maintains coverage for specific oncologic and benign conditions (e.g., HCC ≤5cm, renal cell carcinoma, thyroid nodules) but explicitly lists numerous experimental/investigational procedures and indications that are NOT covered, including RFA for biliary obstructions, pancreatic tumors, and curative treatment in surgical candidates. Billing teams must verify medical necessity against the specific approved indications and ensure claims include appropriate supporting documentation.