What insurance policy changes affect code F52.1?

There are 4 tracked policy changes affecting code F52.1, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code F52.1?

Payers that have issued tracked updates for code F52.1 include: Aetna.

How do I get notified when code F52.1 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code F52.1. 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 code F52.1?

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.

PAYER POLICY CHANGES

F52.1 Insurance Policy Changes

ICD-10 F52.1 is officially defined as "Sexual aversion disorder." code F52.1 is referenced in 4 tracked payer policy changes from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code F52.1 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Oct 2, 2026Medium impact
Female Sexual Dysfunction (FSD) (CPB 0574, reviewed 2026-09-10)
Aetna considers cognitive behavioral therapy and psychotherapy medically necessary for female sexual dysfunction, and considers pelvic floor physical therapy for genito-pelvic pain disorders medically necessary as well. Psychotherapy codes 90832, 90833, 90834, 90836, 90837 and 90838, plus code 97110, are covered when the selection criteria are met. Bibliotherapy, biothesiometry, oxytocin, MDMA, hyaluronic acid, endo-vaginal and vulvar rejuvenation laser, radiofrequency ablation and radiofrequency thermal therapy, platelet-rich plasma and fibrin injections, percutaneous tibial nerve stimulation, sacral neuromodulation, transcranial direct current stimulation, vaginal electrical stimulation, female erectile devices, and stem cell, gene and growth factor therapies are considered experimental, investigational or unproven because of insufficient evidence. Aetna does not cover vibrators, which do not meet its contractual definition of covered durable medical equipment.
Aetna · Identified Aug 15, 2026Medium impact
Female Sexual Dysfunction (FSD) (CPB 0574, reviewed 2026-02-24)
Aetna considers cognitive behavioral therapy or psychotherapy and pelvic floor physical therapy for genito-pelvic pain disorders medically necessary for female sexual dysfunction (FSD). Aetna considers bibliotherapy, biothesiometry, oxytocin, MDMA, percutaneous tibial nerve stimulation, sacral neuromodulation, vaginal electrical stimulation, female erectile devices, and several laser, radiofrequency, injection and regenerative therapies experimental, investigational or unproven for FSD because of insufficient evidence. Aetna does not cover vibrators because they do not meet its contractual definition of covered durable medical equipment, and some Aetna plans exclude drugs or supplies for sexual dysfunction or inadequacy.
Aetna · Identified Aug 15, 2026Medium impact
Carbon Dioxide Laser (CPB 0427, reviewed 2026-07-08)
Aetna's clinical policy bulletin for carbon dioxide laser (CPB 0427) lists the uses it considers medically necessary: condyloma, pelvic pain associated with endometriosis, primary penile tumors (clinical stage Tis, Ta, and T1 Grade 1 to 2), refractory plantar warts, removal of actinic keratoses for members who meet CPB 0567 criteria, removal of superficial basal cell carcinomas, and fractional carbon dioxide laser for hypertrophic burn, traumatic, and surgical scars when conventional therapies have failed. Aetna considers carbon dioxide laser experimental, investigational, or unproven for a list of other indications, including hidradenitis suppurativa, male androgenetic alopecia, onychomycosis, port wine stains, stress urinary incontinence, and vaginal atrophy. Aetna considers carbon dioxide laser treatment of other actinic lesions cosmetic.
Aetna · Identified Aug 13, 2026Medium impact
Erectile Dysfunction and Peyronie's Disease (CPB 0007, reviewed 2026-07-29)
Aetna considers the diagnosis and treatment of erectile dysfunction medically necessary under the criteria in its policy, including self-administered injectable medications, the external penile vacuum pump as a physician-prescribed durable medical equipment alternative to other therapies, and implantable penile prostheses when the documented criteria are met. Surgical correction of Peyronie's disease, such as plaque excisions, venous graft patching, tunica plication or the Nesbit tuck, is medically necessary for members who have the condition for 12 or more months with significant morbidity and have failed conservative medical treatment. Many other treatments, including extracorporeal shock wave therapy and testosterone injection for Peyronie's disease and stem cell therapy for erectile dysfunction, are considered experimental, investigational, or unproven.

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Female Sexual Dysfunction (FSD) (CPB 0574, reviewed 2026-09-10)

Female Sexual Dysfunction (FSD) (CPB 0574, reviewed 2026-02-24)

Carbon Dioxide Laser (CPB 0427, reviewed 2026-07-08)

Erectile Dysfunction and Peyronie's Disease (CPB 0007, reviewed 2026-07-29)

What insurance policy changes affect code F52.1?

Which payers have updated policy for code F52.1?

How do I get notified when code F52.1 policy changes?

Why do payers change policies for code F52.1?