A6025 Insurance Policy Changes

Burn Garments (CPB 0062, reviewed 2026-01-15)

Aetna's Burn Garments policy (CPB 0062) establishes new medical necessity criteria and documentation requirements for compression burn garments. Key changes include: (1) all burn garment claims now require a Standard Written Order (SWO) from the treating practitioner before billing, (2) medical records must substantiate all coverage criteria—supplier statements and physician attestations alone are insufficient, and (3) treating practitioners are limited to MDs, DOs, PAs, NPs, and CNSs; therapists cannot authorize orders. This policy immediately impacts how burn garment claims are submitted and documented.