76998 Insurance Policy Changes

CPT 76998, in plain terms, covers An ultrasound scan used by a doctor during surgery to help guide their surgical instruments to the right location. CPT 76998 is referenced in 4 tracked payer policy changes from Aetna and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 76998 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 76998 on AAPC

Aetna · Identified Oct 16, 2026Medium impact
Peripheral Electrical Nerve Stimulation for Pain (CPB 0011, reviewed 2026-10-14)
Aetna considers TENS units medically necessary durable medical equipment when used as an adjunct or alternative to drugs for acute post-operative pain in the first 30 days after surgery, or for certain chronic, intractable pain not adequately responsive to other methods. Peripherally implanted nerve stimulators are considered medically necessary for intractable neuropathic pain when all listed criteria are met. Percutaneous electrical nerve stimulation is considered medically necessary for chronic low back pain secondary to degenerative disc disease for up to a 30-day period within a multi-modality rehabilitation program, and for diabetic neuropathy or neuropathic pain that has not responded to listed medications. Many other electrical stimulation devices and indications are listed as experimental, investigational, or unproven.
Aetna · Identified Aug 14, 2026Medium impact
Ultrasound Guidance – Selected Indications (CPB 0952, reviewed 2026-04-27)
Aetna Clinical Policy Bulletin 0952 sets coverage rules for ultrasound guidance on selected procedures. CPT 76942 (ultrasonic guidance for needle placement) and 76998 (ultrasonic guidance, intraoperative) are covered when selection criteria are met, and CPT 76937 covers ultrasound guidance for vascular access. The policy lists many nerve blocks, joint, bursa, tendon, aspiration and biopsy procedures as medically necessary with ultrasound guidance, several of them only after an unguided procedure has failed, and it lists procedures for which ultrasound guidance is of no proven benefit and codes that are not covered for specific indications.
Aetna · Identified Aug 12, 2026Medium impact
Varicose Veins (CPB 0050, reviewed 2026-08-03)
Aetna considers ligation, stripping, radiofrequency, endovenous laser and cyanoacrylate closure of the saphenous veins medically necessary when incompetence at the saphenofemoral or saphenopopliteal junction is documented by ultrasound performed within the past 6 months, with junctional reflux of 500 milliseconds or greater, a vein at least 4.5 mm in diameter below the junction, and the symptom criteria in the policy are met. Liquid or foam sclerotherapy (for example Varithena) is medically necessary for symptomatic saphenous veins, varicose tributaries, accessory veins and perforator veins that are 2.5 mm or greater in diameter when the criteria are met, and ambulatory phlebectomy is medically necessary as adjunctive treatment under the same size and symptom criteria. Treatment of veins less than 2.5 mm is considered cosmetic, endovenous ablation of varicose tributaries and accessory veins other than the accessory saphenous vein is considered experimental, investigational or unproven, and sclerotherapy for reflux at the saphenofemoral or saphenopopliteal junction is considered experimental.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Laparoscopic, Percutaneous, and Transcervical Techniques for Uterine Fibroid Myolysis
Laparoscopic or transcervical radiofrequency ablation (RFA) for symptomatic uterine fibroids is considered medically necessary in individuals 18 years and older when all of the policy criteria are met. The criteria include ultrasound evidence of fibroids less than 10 cm in diameter for laparoscopic RFA with Acessa or less than 7 cm for transcervical RFA with Sonata, a desire for a uterine-sparing approach or ineligibility for hysterectomy and other uterine-sparing alternatives, and at least one listed symptom caused directly by the fibroids. Other myolysis techniques, including laser or bipolar needles, cryomyolysis and magnetic resonance imaging-guided laser ablation, are considered investigational.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect CPT 76998?

There are 4 tracked policy changes affecting CPT 76998, including updates from Aetna, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 76998?

Payers that have issued tracked updates for CPT 76998 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 76998 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 76998. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 76998?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

All billing codes J3590 C9399 J3490 99215 99213 99202

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Peripheral Electrical Nerve Stimulation for Pain (CPB 0011, reviewed 2026-10-14)

Ultrasound Guidance – Selected Indications (CPB 0952, reviewed 2026-04-27)

Varicose Veins (CPB 0050, reviewed 2026-08-03)

Laparoscopic, Percutaneous, and Transcervical Techniques for Uterine Fibroid Myolysis

What insurance policy changes affect CPT 76998?

Which payers have updated policy for CPT 76998?

How do I get notified when CPT 76998 policy changes?

Why do payers change policies for CPT 76998?