What insurance policy changes affect code J38.00?

There are 4 tracked policy changes affecting code J38.00, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code J38.00?

Payers that have issued tracked updates for code J38.00 include: Aetna.

How do I get notified when code J38.00 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code J38.00. 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 J38.00?

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

J38.00 Insurance Policy Changes

ICD-10 J38.00 is officially defined as "Paralysis of vocal cords and larynx, unspecified." code J38.00 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 J38.00 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Oct 1, 2026Medium impact
Voice Therapy (CPB 0646, reviewed 2026-09-09)
Aetna considers voice therapy medically necessary to restore the ability to produce speech sounds from the larynx for essential voice tremor, surgery or traumatic injury to the vocal cords, treatment for laryngeal (glottic) carcinoma, muscle tension dysphonia, paradoxical vocal cord motion, post-laryngectomy esophageal speech production, spastic dysphonia, symptomatic benign vocal fold lesions, and vocal cord paralysis. Aetna considers voice therapy not medically necessary for improving voice quality, for occupational or recreational purposes, for self-limited conditions such as acute laryngitis, or as maintenance treatment where symptoms are not improving. Pre-operative voice therapy for benign vocal fold lesions and voice therapy for vocal fold motion impairment following chemotherapy are considered experimental, investigational, or unproven, and voice therapy to feminize or masculinize the voice for transgender individuals is considered not medically necessary and cosmetic.
Aetna · Identified Aug 19, 2026Medium impact
Videostroboscopy (CPB 0305, reviewed 2026-04-17)
Aetna considers videostroboscopy medically necessary as a diagnostic procedure for detecting vocal cord pathology, such as polyps, invasive carcinoma, and vocal cord paresis or paralysis, in members who have received both a mirror-image and an endoscopic examination, where no abnormal function or clinical pathology was found with those tests despite persistent symptoms. Aetna considers videostroboscopy experimental, investigational, or unproven for all other indications because its effectiveness for those indications has not been established. Aetna also considers artificial intelligence-based assessment of videostroboscopy experimental, investigational, or unproven for the diagnosis of vocal fold sulcus (sulcus vocalis).
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 14, 2026Medium impact
Voice Therapy (CPB 0646, reviewed 2025-12-08)
Aetna considers voice therapy medically necessary to restore the ability to produce speech sounds from the larynx for essential voice tremor, surgery or traumatic injury to the vocal cords, treatment for laryngeal (glottic) carcinoma, muscle tension dysphonia, paradoxical vocal cord motion, post-laryngectomy esophageal speech production, spastic dysphonia, symptomatic benign vocal fold lesions, and vocal cord paralysis. Voice therapy is not medically necessary to improve voice quality, for occupational or recreational purposes, or for self-limited conditions such as acute laryngitis, and maintenance treatment where symptoms are not improving is not medically necessary. Pre-operative voice therapy for improving outcomes of surgery for benign vocal fold lesions, and voice therapy for vocal fold motion impairment following chemotherapy, are considered experimental, investigational, or unproven.

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Voice Therapy (CPB 0646, reviewed 2026-09-09)

Videostroboscopy (CPB 0305, reviewed 2026-04-17)

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

Voice Therapy (CPB 0646, reviewed 2025-12-08)

What insurance policy changes affect code J38.00?

Which payers have updated policy for code J38.00?

How do I get notified when code J38.00 policy changes?

Why do payers change policies for code J38.00?