58605 Insurance Policy Changes

Tubal Sterilization (CPB 0657, reviewed 2025-12-08)

Aetna's tubal sterilization policy (CPB 0657) clarifies covered and non-covered procedures effective immediately. Hysteroscopic tubal sterilization (Essure micro-insert) and FemBloc remain experimental/non-covered, while traditional methods (Pomeroy technique, Falope ring, Filshie clip, Hulka-Clemens clip, and salpingectomy) are covered. Billing teams must ensure claims use only approved CPT codes and deny claims for experimental devices like Essure (CPT 0567T, HCPCS A4264).