What insurance policy changes affect code G50.0?

There are 17 tracked policy changes affecting code G50.0, including updates from Excellus BlueCross BlueShield, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code G50.0?

Payers that have issued tracked updates for code G50.0 include: Excellus BlueCross BlueShield, Aetna.

How do I get notified when code G50.0 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code G50.0. 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 G50.0?

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

G50.0 Insurance Policy Changes

ICD-10 G50.0 is officially defined as "Trigeminal neuralgia." code G50.0 is referenced in 17 tracked payer policy changes from Excellus BlueCross BlueShield and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code G50.0 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Excellus BlueCross BlueShield · Effective Nov 16, 2025Medium impact
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy 6.01.12
Excellus BlueCross BlueShield stereotactic radiosurgery and stereotactic body radiation therapy medical policy 6.01.12 has a current effective date of November 16, 2025. Its October 16, 2025 annual review removed life expectancy criteria from the policy criteria. SRS is considered medically appropriate for specified benign, brain and neurologic indications, SBRT is considered medically appropriate for specified extracranial cancers and oligometastatic disease, and SBRT is considered not medically necessary for indications including extrahepatic bile duct cancer, gallbladder cancer and chronic pain.
Aetna · Identified Oct 28, 2026Medium impact
Motor Cortex Stimulation (CPB 0755, reviewed 2026-10-21)
Aetna's Clinical Policy Bulletin 0755 says Aetna considers motor cortex stimulation experimental, investigational, or unproven for the listed indications because its effectiveness has not been established. The listed indications include amyotrophic lateral sclerosis, autism spectrum disorder, cerebral palsy, chronic refractory pain, depression, dysphagia, Parkinson's disease, post-stroke aphasia, post-stroke hemiparesis, seizures, traumatic brain injury and obsessive compulsive disorder, and the bulletin says that list is not all-inclusive. The bulletin also lists CPT, HCPCS and ICD-10 codes that are not covered for the indications listed in the policy.
Aetna · Identified Oct 26, 2026Medium impact
Pulsed Radiofrequency (CPB 0735, reviewed 2026-10-21)
Aetna's Clinical Policy Bulletin 0735 considers pulsed radiofrequency experimental, investigational, or unproven for all indications in its list, because its effectiveness has not been established. The list includes indications such as carpal tunnel syndrome, chronic knee pain, low back pain, trigeminal neuralgia, and headache. The policy also considers the Stimpod NMS460 nerve stimulator for post-amputation pain, combined ganglion impar block and pulsed radiofrequency for pudendal neuralgia, and combined platelet-rich plasma to the Gasserian ganglion and pulsed radiofrequency for trigeminal neuralgia experimental, investigational, or unproven.
Aetna · Identified Oct 21, 2026Medium impact
Intra-oral Appliances for Headaches and Trigeminal Neuralgia (CPB 0688, reviewed 2026-10-14)
Aetna considers intra-oral appliances, such as the Nociceptive Trigeminal Inhibition-Tension Suppression System, experimental, investigational, or unproven for treating headaches and trigeminal neuralgia, because the effectiveness of this approach for these indications has not been established. CPT 21110 and HCPCS codes for occlusal guards, removable appliance therapy, custom sleep apnea appliances, and oral appliance therapy are listed as not covered for the indications in this policy. Diagnosis codes for migraine, other headache syndromes, trigeminal neuralgia, and headache are also listed as not covered for the indications in this policy.
Aetna · Identified Oct 4, 2026Medium impact
Neuralgia Inducing Cavitational Osteonecrosis (NICO) and Ultrasonograph Bone Densitometer to Detect NICO (CPB 0642, reviewed 2026-09-09)
Surgery for neuralgia inducing cavitational osteonecrosis (NICO) is considered experimental, investigational or unproven, including scraping of infected cavities and removal of root-canal-treated teeth. Rinsing the cavity with colloidal silver, chelation therapy with intravenous vitamin C, and bone graft replacement for NICO-related diagnoses are also considered experimental, investigational or unproven. Devices that image the jawbones to diagnose NICO or NICO-type conditions are considered experimental, investigational or unproven because there is no adequate scientific evidence to support their clinical value.
Aetna · Identified Aug 18, 2026Medium impact
Trigeminal Neuralgia: Treatments (CPB 0374, reviewed 2026-06-29)
Aetna considers surgery for trigeminal neuralgia medically necessary when the condition has persisted for at least 6 months despite pharmacotherapy (carbamazepine, oxcarbazepine, lamotrigine, baclofen, gabapentin, pregabalin or phenytoin) or the member is unable to tolerate the side effects of those medications. The medically necessary procedures are balloon compression, CyberKnife, gamma knife, microvascular decompression, percutaneous glycerol rhizotomy (or injections), percutaneous radiofrequency rhizolysis or rhizotomy, and trigeminal nerve blocks for refractory cases, while surgery that does not meet these criteria is considered experimental, investigational, or unproven. Acupuncture, botulinum toxin, pulsed radiofrequency, spinal cord stimulation, deep brain stimulation, intravenous ketamine, intravenous lidocaine, erenumab and trigeminal tractotomy are considered experimental, investigational, or unproven because their effectiveness has not been established.
Aetna · Identified Aug 18, 2026Medium impact
Nerve Blocks (CPB 0863, reviewed 2026-07-23)
Aetna Clinical Policy Bulletin 0863 covers nerve blocks and lists which ones it considers medically necessary. Covered uses include adductor canal, femoral, fascia iliaca, erector spinae plane and transversus abdominis plane blocks for post-operative pain after specific surgeries, and celiac plexus block for cancer pain, while peripheral nerve blocks for chronic pain are covered only as an active component of a comprehensive pain management program. Blocks listed as experimental and investigational include genicular nerve blocks and peripheral nerve blocks used as the sole treatment for chronic non-malignant pain, because the effectiveness of these approaches has not been established.
Aetna · Identified Aug 17, 2026Medium impact
Neuralgia Inducing Cavitational Osteonecrosis (NICO) and Ultrasonograph Bone Densitometer to Detect NICO (CPB 0642, reviewed 2025-12-15)
Aetna's Clinical Policy Bulletin 0642 considers surgery for neuralgia inducing cavitational osteonecrosis (NICO) related diagnoses experimental, investigational or unproven, including scraping of infected cavities and removal of root-canal-treated teeth. Other NICO therapies are also listed as experimental, investigational or unproven, namely rinsing the cavity with colloidal silver, chelation therapy, intravenous vitamin C and bone graft replacement. Devices that image the jawbones to diagnose NICO or NICO-type conditions are experimental, investigational or unproven because there is no adequate scientific evidence to support their clinical value, and the policy states that current evidence is insufficient to support NICO as a distinct, validated clinical entity.
Aetna · Identified Aug 17, 2026Medium impact
Motor Cortex Stimulation (CPB 0755, reviewed 2026-02-24)
Aetna's Clinical Policy Bulletin 0755 on motor cortex stimulation, with a policy history last review of 10/21/2026, considers motor cortex stimulation experimental, investigational or unproven for many indications because its effectiveness has not been established. The list includes amyotrophic lateral sclerosis, autism spectrum disorder, cerebral palsy, chronic refractory pain (such as central pain syndromes, complex regional pain syndrome, phantom limb pain, thalamic pain and trigeminal neuropathic pain), depression, dysphagia, dystonia secondary to a focal basal ganglia lesion, movement disorders, obsessive compulsive disorder, Parkinson's disease, post-stroke aphasia, post-stroke hemiparesis, seizures, traumatic brain injury, and use of motor cortex stimulation during deep brain stimulator implantation. The policy lists CPT codes 61850, 61860, 61885, 61886, 64568, 95961, 95962 and 95970 as not covered for the indications it lists.
Aetna · Identified Aug 17, 2026Medium impact
Stereotactic Radiosurgery (CPB 0083, reviewed 2026-03-11)
Aetna considers stereotactic radiosurgery (SRS) medically necessary in certain circumstances, and refers to the eviCore Healthcare Radiation Therapy Clinical Guidelines for medical necessity criteria. Cranial SRS is medically necessary for benign brain and spinal tumors, cranial arteriovenous malformations, cavernous malformations and hemangiomas, trigeminal neuralgia that has not responded to more conservative treatments, severe essential tremor not adequately responsive to standard medical therapy, disabling tremor in Parkinson's disease for patients who meet thalamotomy criteria but are not surgical candidates, and primary brain tumors and primary or secondary tumors involving the spine. For brain metastases, SRS is considered appropriate with a Karnofsky Performance Status of 40 or greater (or expected to return to 70 or greater), or an ECOG status of 3 or less (or expected to return to 2 or less), fewer than 10 metastatic lesions, and control of or expected control of extracranial disease. Stereotactic body radiation therapy is medically necessary for liver or hepatobiliary cancer stage I to II, organ-confined prostate cancer, inoperable stage I or IIA lung cancer, unresectable stage I to III pancreatic cancer, recurrent disease requiring re-irradiation, and oligometastatic breast, non-small cell lung, colorectal, renal cell, prostate, sarcoma, melanoma and head and neck cancers with 1 to 5 total metastases, and Aetna considers SRS experimental, investigational, or unproven for cluster headaches, epilepsy (except when associated with treatment of arteriovenous malformations or brain tumors), and mammographic microcalcification.
Aetna · Identified Aug 15, 2026Medium impact
Quantitative Sensory Testing Methods (CPB 0357, reviewed 2026-05-22)
Quantitative sensory testing (QST), current perception threshold (CPT) testing, voltage-actuated sensory nerve conduction threshold (VsNCT) testing, and quantitative thermal testing for early diagnosis of leprosy are considered experimental, investigational, or unproven for the uses listed in this policy, because their effectiveness or clinical value has not been established. Listed uses include evaluating fibromyalgia pain, chronic itch, chronic pelvic pain, and shoulder pain, and diagnosing restless legs syndrome and small fiber neuropathy in postural orthostatic tachycardia syndrome. CPT codes 0106T through 0110T and HCPCS code G0255 are not covered for the listed indications.
Aetna · Identified Aug 15, 2026Medium impact
Pulsed Radiofrequency (CPB 0735, reviewed 2025-10-29)
Aetna considers pulsed radiofrequency (PRF) experimental, investigational, or unproven for all indications listed in CPB 0735, including carpal tunnel syndrome, chronic knee pain, low back pain, trigeminal neuralgia, and chronic migraine. The policy also lists the Stimpod NMS460 nerve stimulator and a wearable pulsed radiofrequency therapy device for post-amputation pain as experimental, investigational, or unproven, and it gives the same status to combined ganglion impar block and PRF for pudendal neuralgia and to combined platelet-rich plasma to the Gasserian ganglion and PRF for trigeminal neuralgia. There are no specific CPT or HCPCS codes for pulsed radiofrequency, and the policy lists ICD-10 codes that are not covered for the indications listed in the CPB.
Aetna · Identified Aug 14, 2026Medium impact
Coblation (CPB 0475, reviewed 2026-07-02)
Aetna considers coblation tonsillectomy medically necessary for peri-tonsillar abscess, recurrent middle ear infection where tonsillar hypertrophy is believed to be an exacerbating factor, recurrent or chronic tonsillar infection, and tonsillar hypertrophy leading to respiratory symptoms or airway obstruction. Aetna considers many other coblation uses experimental, investigational or unproven because their effectiveness has not been established, including coblation adenoidectomy, coblation nasal septal swell body reduction, coblation with or without gastrocnemius release for plantar fasciitis, coblation devices such as the Topaz Microdebrider for insertional Achilles tendinopathy and lateral epicondylitis, and radiofrequency to the nasal valve (Vivaer Nasal Airway Remodeling) for nasal airway obstruction. The policy lists cervical coblation nucleoplasty, coblation non-thermal volumetric tissue reduction, and several other coblation procedures as CPT codes not covered for the indications listed in the policy.
Aetna · Identified Aug 14, 2026Medium impact
Attended Electroencephalographic (EEG) Video Monitoring (CPB 0322, reviewed 2026-06-08)
Aetna considers attended electroencephalographic (EEG) video monitoring performed in a healthcare facility medically necessary when diagnosis remains uncertain after neurological examinations and standard EEG studies within the past 90 days, non-neurological causes such as syncope or cardiac arrhythmias have been ruled out, and documentation shows that extended ambulatory EEG monitoring as an outpatient would not be sufficient for the member's needs. Covered indications include differentiating epileptic events from psychogenic seizures, establishing the specific type of epilepsy in poorly characterized seizure types, establishing the diagnosis of epilepsy and evaluating response to treatment in children 3 years of age or younger, children with severe cognitive deficits, and older persons unable to communicate due to disability, evaluating newborns with proven or suspected acute brain injury and co-morbid encephalopathy, and identifying a seizure focus in members with intractable epilepsy who are being considered for epilepsy surgery. Monitoring longer than 7 days is medically necessary when events are so infrequent that they would likely not be detected within one week, when an extended stay is needed for care of an adverse event, or when medication adjustments require ongoing monitoring that cannot be safely performed on an outpatient basis. Once the cause of seizures and the specific type of epilepsy have been established, continued video EEG monitoring in older children and adults is considered not medically necessary. Attended EEG video monitoring for medical clearance to operate a motor vehicle is not considered medically necessary, and it is considered experimental, investigational or unproven for other indications including obstructive sleep apnea, assessment of the effectiveness of drug treatment in epilepsies, amyotrophic lateral sclerosis, cardiac arrest, chronic fatigue, coma, diagnosis of brain death, encephalopathy and headache.
Aetna · Identified Aug 14, 2026Medium impact
Magnetic Resonance Neurography (CPB 0387, reviewed 2025-08-01)
Aetna considers magnetic resonance neurography experimental, investigational, or unproven because the medical literature on its clinical use remains in early stages of development. The policy lists ICD-10 codes for nerve, nerve root and plexus disorders (G50.0 through G59) and for injury to nerves and spinal cord (S04 through S94 ranges) as not covered for the indications listed. There are no specific CPT or HCPCS codes for magnetic resonance neurography.
Aetna · Identified Aug 14, 2026Medium impact
Cryoanalgesia and Therapeutic Cold (CPB 0297, reviewed 2026-04-14)
Aetna considers passive cold compression therapy units (such as the Aircast Cryo/Cuff, Polar Care Cub and Polar Care Packs) medically necessary DME to control swelling, edema, hematoma, hemarthrosis and pain, and considers passive hot and cold therapy medically necessary. Cryoanalgesia is considered medically necessary for temporary relief of pain due to chronic refractory trigeminal neuralgia when the selection criteria are met, and for pre-operative, intra-operative and post-operative cryoanalgesia for post-operative pain management related to the Nuss or Ravitch procedure. Active cold units with mechanical pumps, devices that deliver both hot and cold therapy, cryoneurolysis for abdominal pain associated with pancreatic cancer, acute pain, cervicogenic headache, occipital neuralgia, peripheral neuropathic pain, phantom limb pain and post-herpetic neuralgia, pre-operative cryoneurolysis for pain following total knee arthroplasty, prophylactic hypothermia for traumatic brain injury, therapeutic hypothermia for cardiogenic shock or hemorrhagic stroke, intra-brain hypothermia for concussion, submucosal cryolysis, the Cooral intraoral cooling system, and bedside percutaneous cryoneurolysis for acute rib fracture pain are considered experimental, investigational or unproven. Passive cold compression therapy units for all other indications, and intra-operative and post-operative cryoanalgesia for post-thoracotomy pain, post-tonsillectomy pain, post-sternotomy pain and post-mastectomy pain, are also considered experimental, investigational or unproven.
Aetna · Identified Aug 18, 2026Low impact
Intra-oral Appliances for Headaches and Trigeminal Neuralgia (CPB 0688, reviewed 2025-12-29)
Aetna's Clinical Policy Bulletin 0688 (reviewed 2025-12-29, historical material first detected 2026-08-18) states that intra-oral appliances such as the NTI-tss are considered experimental, investigational, or unproven for headaches and trigeminal neuralgia, and lists dental and sleep-appliance codes plus ICD-10 headache and trigeminal neuralgia codes as not covered for these indications. Practices should treat these services as non-covered for the stated diagnoses, confirm current applicability on Aetna's site, and not bill them to Aetna for those indications without verifying the plan's current position.

Watch G50.0

Get one email when a payer policy names G50.0, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

Get alerts for changes like this

Save a search and get email alerts when a new policy change matches your filters: daily or weekly, your choice, on every plan.

Create a free alert How Policy Monitoring works

Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy 6.01.12

Motor Cortex Stimulation (CPB 0755, reviewed 2026-10-21)

Pulsed Radiofrequency (CPB 0735, reviewed 2026-10-21)

Intra-oral Appliances for Headaches and Trigeminal Neuralgia (CPB 0688, reviewed 2026-10-14)

Neuralgia Inducing Cavitational Osteonecrosis (NICO) and Ultrasonograph Bone Densitometer to Detect NICO (CPB 0642, reviewed 2026-09-09)

Trigeminal Neuralgia: Treatments (CPB 0374, reviewed 2026-06-29)

Nerve Blocks (CPB 0863, reviewed 2026-07-23)

Neuralgia Inducing Cavitational Osteonecrosis (NICO) and Ultrasonograph Bone Densitometer to Detect NICO (CPB 0642, reviewed 2025-12-15)

Motor Cortex Stimulation (CPB 0755, reviewed 2026-02-24)

Stereotactic Radiosurgery (CPB 0083, reviewed 2026-03-11)

Quantitative Sensory Testing Methods (CPB 0357, reviewed 2026-05-22)

Pulsed Radiofrequency (CPB 0735, reviewed 2025-10-29)

Coblation (CPB 0475, reviewed 2026-07-02)

Attended Electroencephalographic (EEG) Video Monitoring (CPB 0322, reviewed 2026-06-08)

Magnetic Resonance Neurography (CPB 0387, reviewed 2025-08-01)

Cryoanalgesia and Therapeutic Cold (CPB 0297, reviewed 2026-04-14)

Intra-oral Appliances for Headaches and Trigeminal Neuralgia (CPB 0688, reviewed 2025-12-29)

What insurance policy changes affect code G50.0?

Which payers have updated policy for code G50.0?

How do I get notified when code G50.0 policy changes?

Why do payers change policies for code G50.0?