64804 Insurance Policy Changes

Thoracoscopic Sympathectomy (CPB 0310, reviewed 2026-05-20)

Aetna updated its thoracoscopic sympathectomy policy (CPB 0310) to specify medical necessity criteria for 8 specific conditions including causalgia, CPVT, Long QT syndrome, Raynaud's disease, VT/VF storm, vascular occlusive disease, visceral pain, and intractable hyperhidrosis. The policy explicitly designates certain indications (acne, plantar hyperhidrosis, facial blushing, heart failure) as experimental, investigational, or cosmetic and therefore non-covered. Billing teams must verify medical necessity documentation against these criteria before claim submission.