72192 Insurance Policy Changes

Kidney Stones: Selected Interventions (CPB 0392, reviewed 2026-06-23)

Aetna has updated its kidney stone policy (CPB 0392, effective 2026-06-23) to designate four interventions as experimental/investigational and not covered: acoustic enhancer microbubble cavitation lithotripsy (CPT 0991T), CT/MRI screening for asymptomatic urolithiasis (CPT 72192-72197), calcifying nanoparticles for risk assessment, and genetic/molecular analysis for risk assessment. Billing teams must deny claims for these specific codes when submitted for the listed indications and ensure prior authorization workflows reflect non-coverage status.