76870 Insurance Policy Changes

Scrotal Ultrasonography (CPB 0532, reviewed 2026-07-29)

Aetna has updated its scrotal ultrasonography medical necessity policy (CPT 76870) effective 2026-07-29. The policy clearly defines covered indications (9 specific conditions including testicular torsion, trauma, infertility evaluation, and varicoceles) and explicitly excludes coverage for initial infertility evaluation without difficult/inadequate exam findings and surveillance of testicular microlithiasis without additional risk factors. Billing teams must ensure claims include appropriate ICD-10 diagnosis codes from the covered list to avoid denials.