What insurance policy changes affect code L05.02?

There are 2 tracked policy changes affecting code L05.02, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code L05.02?

Payers that have issued tracked updates for code L05.02 include: Aetna.

How do I get notified when code L05.02 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code L05.02. 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 L05.02?

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

L05.02 Insurance Policy Changes

ICD-10 L05.02 is officially defined as "Pilonidal sinus with abscess." code L05.02 is referenced in 2 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 L05.02 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Only a small number of policies match this filter. Check back as coverage expands.

Aetna · Identified Oct 21, 2026Medium impact
Ultrasound Therapy for Wound Healing (CPB 0746, reviewed 2026-10-16)
Aetna considers ultrasound therapy, including high-frequency ultrasound and non-contact low-frequency ultrasound devices, experimental, investigational, or unproven for wound healing and for reduction of chronic wound pain, because the effectiveness of this approach for these indications has not been established. CPT 97610, low-frequency non-contact non-thermal ultrasound per day, is listed as not covered for the indications in this policy. Examples of ultrasound therapy named in this policy include the FAST procedure, the MIST Therapy System, the Qoustic Wound Therapy System, and the Sonoca 180/185 Wound Care System.
Aetna · Identified Aug 18, 2026Medium impact
Ultrasound Therapy for Wound Healing (CPB 0746, reviewed 2025-11-26)
Aetna considers ultrasound therapy for wound healing and for reduction of chronic wound pain experimental, investigational, or unproven, because its effectiveness for these indications has not been established. This includes high-frequency ultrasound and non-contact low-frequency ultrasound devices, such as the MIST Therapy System, the Qoustic Wound Therapy System, and the Sonoca 180/185 Wound Care System. CPT 97610 is listed as not covered for the indications in this policy.

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Ultrasound Therapy for Wound Healing (CPB 0746, reviewed 2026-10-16)

Ultrasound Therapy for Wound Healing (CPB 0746, reviewed 2025-11-26)

What insurance policy changes affect code L05.02?

Which payers have updated policy for code L05.02?

How do I get notified when code L05.02 policy changes?

Why do payers change policies for code L05.02?