L73.2 Insurance Policy Changes

ICD-10 L73.2 is officially defined as "Hidradenitis suppurativa." code L73.2 is referenced in 11 tracked payer policy changes from Aetna and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code L73.2 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Sep 30, 2026Medium impact
Phototherapy for Acne (CPB 0656, reviewed 2026-09-15)
Aetna considers phototherapy and photodynamic therapy treatments for acne experimental, investigational, or unproven for acne vulgaris because of insufficient evidence of effectiveness in comparison with established treatments. The listed treatments include the ClearLight Acne PhotoClearing System, Omnilux Blue Photo Dynamic Therapy, laser therapy such as the AviClear Laser System, intense pulsed light, light-emitting diode therapy, photopneumatic therapy, and home-based devices, along with several other light, laser and photodynamic therapy approaches. Aetna also considers laser therapy, photodynamic therapy with topical 5-ALA or Levulan, and phototherapy experimental, investigational, or unproven for acne inversa (hydradenitis suppurativa), and considers combined surgery and photodynamic therapy experimental for cystic acne of the scalp.
Aetna · Identified Aug 18, 2026Medium impact
Laser Treatment for Psoriasis and Other Selected Skin Conditions (CPB 0577, reviewed 2026-07-15)
Aetna considers excimer and pulsed dye laser treatment medically necessary for persons with mild-to-moderate localized plaque psoriasis affecting 10% or less of body area who have failed to adequately respond to 3 or more months of topical treatments, including at least 3 of the listed agents. No more than 13 laser treatments per course and 3 courses per year are generally considered medically necessary, and additional courses are not considered medically necessary if the person fails to respond to an initial course, as documented by a reduction in PASI score or other objective response measurement. The policy also covers laser hair removal for recurrent pilonidal cyst, laser treatment for acne keloidalis nuchae and penile intraepithelial neoplasia, and Nd:YAG laser for hidradenitis suppurativa. Combined pulsed dye laser and UVB for localized plaque psoriasis, and excimer or pulsed dye laser for psoriasis other than plaque psoriasis, are considered experimental, investigational or unproven, as is laser treatment for the other listed skin conditions. Laser treatment for acne scarring, keratosis pilaris, pearly penile papules and rhinophyma is considered cosmetic.
Aetna · Identified Aug 17, 2026Medium impact
Adalimumab (CPB 0655, reviewed 2026-07-13)
Aetna's clinical policy bulletin 0655 sets the coverage rules for adalimumab (Humira) and its biosimilars under commercial medical plans. Adalimumab is considered medically necessary for rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, Crohn's disease, ulcerative colitis, plaque psoriasis, hidradenitis suppurativa, non-infectious uveitis, Behcet's disease, pyoderma gangrenosum and immune checkpoint inhibitor-related inflammatory arthritis when the listed criteria are met. The policy also states that Hulio has been discontinued as of 1/1/2026, and that adalimumab-fkjp is the unbranded generic of Hulio.
Aetna · Identified Aug 16, 2026Medium impact
Secukinumab (Cosentyx) (CPB 0905, reviewed 2026-08-11)
Aetna covers secukinumab (Cosentyx) for commercial medical plans when the criteria for the specific indication are met. The covered indications are plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, enthesitis-related arthritis, and hidradenitis suppurativa, and each has its own prior treatment and disease severity criteria. Continuation of therapy requires a positive clinical response, and intravenous Cosentyx requires precertification.
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
Thermography (CPB 0029, reviewed 2026-03-12)
Aetna considers thermography experimental, investigational, or unproven for all indications listed in the policy, including detection and screening for breast cancer, diagnosis of carpal tunnel syndrome, diagnosis of musculoskeletal injuries, and monitoring of diabetes mellitus. Aetna also considers dynamic infrared blood perfusion imaging (DIRI) for intra-operative and post-operative perfusion assessment experimental, investigational, or unproven. CPT 93740 (temperature gradient studies) is not covered for the indications listed.
Aetna · Identified Aug 14, 2026Medium impact
Dermabrasion, Chemical Peels, and Acne Surgery (CPB 0251, reviewed 2026-04-15)
Aetna considers dermabrasion for superficial basal cell carcinomas and pre-cancerous actinic keratoses, medium and deep chemical peels for actinic keratoses when there are 15 or more lesions, and specified acne surgery procedures medically necessary when criteria are met. Dermabrasion for active acne, diffuse silicone granuloma, dyschromias, keloids, melasma and vitiligo, chemical peels for active acne, and fractional radiofrequency and micro-needling for acne scars and other listed indications are considered experimental, investigational, or unproven. Dermabrasion for scar revision and removal of acne scars, and chemical peels for acne scarring, melasma, and skin wrinkling or lentigines, are considered cosmetic.
Aetna · Identified Aug 14, 2026Medium impact
Pulsed Dye Laser Treatment (CPB 0559, reviewed 2025-08-22)
Pulsed dye laser treatment is medically necessary for actinic keratoses that failed to adequately respond to imiquimod, 5-FU, or cryosurgery, for capillary malformation with overgrowth or vascular malformation, for genital warts when home therapy with podophyllotoxin or imiquimod has failed, for granuloma faciale, for infantile hemangiomas, and for port wine stains and other hemangiomas on the face and neck. It is also medically necessary for keloids or hypertrophic scars from an injury or surgical procedure that cause significant pain requiring chronic analgesic medication or significant functional impairment, for multiple superficially located glomangiomas in the face and neck where surgical excision is not practical, for pyogenic granuloma in the face and neck, for symptomatic angiolymphoid hyperplasia that has failed medical therapy, and for verrucae after at least two conventional therapies have failed. Pulsed dye laser is considered experimental, investigational, or unproven for other conditions, including active acne, onychomycosis, hidradenitis suppurativa, molluscum contagiosum, and morphea, and cosmetic for conditions including rosacea, facial redness, solar lentigines, and striae distensae.
Aetna · Identified Aug 13, 2026Medium impact
Phototherapy for Acne (CPB 0656, reviewed 2025-10-03)
Aetna considers the light, laser and photodynamic treatments for acne vulgaris listed in this policy experimental, investigational or unproven, because evidence of effectiveness compared with established treatments is insufficient. The list includes the ClearLight and Omnilux Blue systems, the AviClear laser, intense pulsed light, light-emitting diode therapy, photopneumatic therapy, the CellFX nano-pulse system, and home-based devices that deliver heat, light, laser, suction or ultraviolet therapy. Aetna also considers laser therapy, PDT with topical 5-ALA or Levulan, and phototherapy experimental for acne inversa (hidradenitis suppurativa), and combined surgery and PDT experimental for cystic acne of the scalp. The policy lists the CPT, HCPCS and ICD-10 codes in its code table as not covered for the indications it names, including L70.0 through L70.9 for acne and L73.2 for hidradenitis suppurativa.
Aetna · Identified Aug 13, 2026Medium impact
Etanercept (CPB 0315, reviewed 2026-07-08)
Aetna's Clinical Policy Bulletin 0315 considers etanercept (Enbrel) medically necessary for rheumatoid arthritis, articular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, plaque psoriasis, reactive arthritis, hidradenitis suppurativa, graft versus host disease, Behcet's disease and immune checkpoint inhibitor-related toxicity when the listed criteria are met. Initial criteria differ by indication and include prior treatment with other drugs for several of them, and continuation of therapy requires a positive clinical response. Aetna considers all other indications experimental, investigational, or unproven, including concomitant use with another biologic or targeted synthetic drug for the same indication.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Hidradenitis Suppurativa (HS)
Prior authorization is required for hidradenitis suppurativa (HS) treatment with Cosentyx (secukinumab), Hadlima (adalimumab-bwwd) and Simlandi (adalimumab-ryvk). Hadlima and Simlandi are the adalimumab formulary options effective 01/01/2025. Abrilada, Amjevita, Bimzelx (bimekizumab-bkzx), Cyltezo, Hulio, Humira, Hyrimoz, Idacio, Yuflyma and Yusimry are not covered on any BCBSMS Formulary. The 10/21/2026 policy history entry removed the documented Hurley Stage requirement and the documented intolerance, contraindication or hypersensitivity requirement from the initial criteria, and removed the documented clinical improvement requirement from the renewal criteria.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code L73.2?

There are 11 tracked policy changes affecting code L73.2, including updates from Aetna, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code L73.2?

Payers that have issued tracked updates for code L73.2 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code L73.2 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code L73.2. 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 L73.2?

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.

All billing codes J3590 C9399 J3490 99215 99213 99202

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Phototherapy for Acne (CPB 0656, reviewed 2026-09-15)

Laser Treatment for Psoriasis and Other Selected Skin Conditions (CPB 0577, reviewed 2026-07-15)

Adalimumab (CPB 0655, reviewed 2026-07-13)

Secukinumab (Cosentyx) (CPB 0905, reviewed 2026-08-11)

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

Thermography (CPB 0029, reviewed 2026-03-12)

Dermabrasion, Chemical Peels, and Acne Surgery (CPB 0251, reviewed 2026-04-15)

Pulsed Dye Laser Treatment (CPB 0559, reviewed 2025-08-22)

Phototherapy for Acne (CPB 0656, reviewed 2025-10-03)

Etanercept (CPB 0315, reviewed 2026-07-08)

Hidradenitis Suppurativa (HS)

What insurance policy changes affect code L73.2?

Which payers have updated policy for code L73.2?

How do I get notified when code L73.2 policy changes?

Why do payers change policies for code L73.2?