What insurance policy changes affect code G51.0?

There are 8 tracked policy changes affecting code G51.0, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code G51.0?

Payers that have issued tracked updates for code G51.0 include: Aetna.

How do I get notified when code G51.0 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code G51.0. 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 G51.0?

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

G51.0 Insurance Policy Changes

ICD-10 G51.0 is officially defined as "Bell's palsy." code G51.0 is referenced in 8 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 G51.0 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Oct 12, 2026Medium impact
Nerve Grafting and Reconstruction: Selected Indications (CPB 0416, reviewed 2026-10-06)
Nerve allograft (Avance) is medically necessary for repair of short-to-medium sensory nerve gaps of 30 mm or less in the upper extremity, and CPT 64912 and 64913 are covered when those selection criteria are met. Nerve allograft for motor nerve repair, long gaps over 30 mm, large-diameter nerves, lower extremity reconstruction and all other indications not noted as medically necessary is experimental, investigational or unproven. Sural, cavernous and genitofemoral nerve grafts during radical retropubic prostatectomy, collagen and synthetic or xenograft nerve wraps and conduits for all indications, nerve wrapping for compression neuropathy, and vascularized nerve grafts for a nerve gap are also listed as not covered.
Aetna · Identified Oct 5, 2026Medium impact
Infrared Therapy (CPB 0604, reviewed 2026-09-09)
Aetna considers infrared coagulation medically necessary for anal dysplasia and for members with grade I, II, or III internal hemorrhoids that are painful or persistently bleeding. Low-level infrared light therapy is considered experimental, investigational, or unproven for a long list of indications, including osteoarthritis, migraines, stroke, and diabetes mellitus, and the infrared glove is unproven for Raynaud's syndrome and all other indications. CPT 46930 is covered when selection criteria are met, while CPT 97026 and HCPCS codes A4639 and E0221 are not covered for the listed indications.
Aetna · Identified Oct 4, 2026Medium impact
Nerve Grafting and Reconstruction: Selected Indications (CPB 0416, reviewed 2026-09-28)
Nerve allograft (Avance) is considered medically necessary for repair of short-to-medium sensory nerve gaps of 30 mm or less in the upper extremity. CPT 64912 and 64913 are covered when those selection criteria are met. Sural, cavernous and genitofemoral nerve grafts during radical retropubic prostatectomy, nerve allograft for motor nerve repair, long gaps over 30 mm, large-diameter nerves, lower extremity reconstruction, collagen conduits, and synthetic or xenograft nerve grafts and wraps for all indications are considered experimental, investigational or unproven. Cross-palm nerve grafting, intra-operative electrical stimulation, nerve wrapping for compression neuropathy, phrenic nerve reconstruction for diaphragmatic paralysis (other than prompt repair of acute phrenic nerve transection due to trauma or surgery), and vascularized nerve grafts for a nerve gap are also considered experimental, investigational or unproven.
Aetna · Identified Aug 18, 2026Medium impact
Infrared Therapy (CPB 0604, reviewed 2025-12-02)
Aetna considers infrared coagulation medically necessary for anal dysplasia and for grade I, grade II, or grade III internal hemorrhoids that are painful or persistently bleeding. Infrared light treatment is considered medically necessary as a heat modality in physical therapy. Low-level infrared light therapy, including the Anodyne Therapy System, is considered experimental, investigational, or unproven for many indications such as diabetic and non-diabetic peripheral neuropathy, chronic non-healing wounds, lymphedema, migraines, and osteoarthritis, and the infrared glove is considered experimental for Raynaud's syndrome and all other indications.
Aetna · Identified Aug 17, 2026Medium impact
Nerve Grafting and Reconstruction: Selected Indications (CPB 0416, reviewed 2025-06-09)
Aetna's Clinical Policy Bulletin 0416 sets the medical necessity rules for nerve grafting and nerve reconstruction. Nerve allograft (Avance) is medically necessary for repair of short-to-medium sensory nerve gaps of 30 mm or less in the upper extremity, while nerve allograft for motor nerve repair, long gaps over 30 mm, large-diameter nerves, lower extremity reconstruction and all other indications not listed as medically necessary is experimental, investigational or unproven. Collagen conduits and synthetic or xenograft nerve grafts, including the AxoGen, Integra, NeuraGen, NeuraWrap, Neuromatrix and NeuroMend products, are experimental, investigational or unproven for all indications, and so are sural, cavernous and genitofemoral nerve grafts during radical retropubic prostatectomy, nerve wrapping for compression neuropathy, cross-palm nerve grafting for ulnar neuropathy, vascularized nerve grafts, intra-operative electrical stimulation of peripheral nerves in the upper extremity, and phrenic nerve reconstruction for diaphragmatic paralysis (this does not apply to prompt repair of acute phrenic nerve transection due to trauma or surgery).
Aetna · Identified Aug 16, 2026Medium impact
Lyme Disease and other Tick-Borne Diseases (CPB 0215, reviewed 2026-07-21)
Aetna considers outpatient IV antibiotic therapy medically necessary for Lyme disease only when the clinical presentation is compatible with the disease and supported by two-tier serologic testing. Once Lyme disease is definitively diagnosed, an initial 4-week course of outpatient IV antibiotic therapy is medically necessary for persistent Lyme arthritis after failing a 4-week course of oral antibiotics, for moderate-to-severe cardiac or neurologic involvement, and for specified cases in pregnant women, and one repeat 4-week course is medically necessary with objective evidence of relapse, progression of organ damage, or a new focus or type of organ damage. Aetna considers IV antibiotic therapy for early Lyme disease, additional antibiotic therapy for post-treatment persistently fatigued patients, and a range of listed tests and treatments experimental, investigational, or unproven.
Aetna · Identified Aug 16, 2026Medium impact
Eyelid Surgery (CPB 0084, reviewed 2026-03-03)
Upper lid blepharoplasty is medically necessary to correct prosthesis difficulties in an anophthalmia socket, to relieve painful blepharospasm, to treat peri-orbital sequelae of thyroid disease and nerve palsy, or to remove excess upper eyelid tissue causing functional visual impairment when photographs and visual field testing from the past 12 months meet the stated criteria. Upper lid ptosis repair and brow ptosis repair for functional visual impairment are medically necessary when their listed criteria are met, and ectropion and entropion repair are medically necessary to repair defects predisposing to corneal or conjunctival injury when selection criteria are met. Surgical correction of congenital ptosis is medically necessary to allow proper visual development in infants and children when the ptosis interferes with the field of vision and the child has abnormal head posture, amblyopia or strabismus, and congenital ptosis surgery is considered cosmetic when performed for mild ptosis that is only of cosmetic concern.
Aetna · Identified Aug 15, 2026Medium impact
Facial Nerve Paralysis (CPB 0745, reviewed 2025-10-30)
Aetna's Clinical Policy Bulletin 0745 covers facial nerve surgery for chronic facial paralysis only when the paralysis has persisted for more than 12 months, has caused impaired functional deficit in mastication, speech, or vision, and there is no reasonable likelihood of spontaneous return of function as determined by electromyography or electroneurography. Blink reflex testing for the diagnosis of Bell's palsy and gold weight eyelid implants for the treatment of Bell's palsy are covered as medically necessary. The policy treats combined electrophysiological tests, neuromuscular ultrasound, botulinum toxin, electrical stimulation, acupuncture, hyperbaric oxygen therapy, facial retraining therapy and several other listed treatments for Bell's palsy as experimental, investigational, or unproven.

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Nerve Grafting and Reconstruction: Selected Indications (CPB 0416, reviewed 2026-10-06)

Infrared Therapy (CPB 0604, reviewed 2026-09-09)

Nerve Grafting and Reconstruction: Selected Indications (CPB 0416, reviewed 2026-09-28)

Infrared Therapy (CPB 0604, reviewed 2025-12-02)

Nerve Grafting and Reconstruction: Selected Indications (CPB 0416, reviewed 2025-06-09)

Lyme Disease and other Tick-Borne Diseases (CPB 0215, reviewed 2026-07-21)

Eyelid Surgery (CPB 0084, reviewed 2026-03-03)

Facial Nerve Paralysis (CPB 0745, reviewed 2025-10-30)

What insurance policy changes affect code G51.0?

Which payers have updated policy for code G51.0?

How do I get notified when code G51.0 policy changes?

Why do payers change policies for code G51.0?