Auditory Processing Disorder (APD) (CPB 0668, reviewed 2025-10-07)

By October 7, 2025: Billing team must immediately implement denial protocols for all Aetna claims related to Auditory Processing Disorder (APD). (1) Update billing system to automatically deny or flag for denial all claims with CPT codes 92507, 92508, 92521-92524, 92551-92588, 92620, 92621, HCPCS codes S9128 or V5008, and ICD-10 codes H93.25 or H93.291-H93.299 when billed to Aetna. (2) Do NOT submit claims for APD-related diagnostic testing, auditory processing evaluations, speech therapy for APD, or auditory integration therapy to Aetna—they will be denied as experimental/investigational. (3) Train front-desk and clinical staff to inform patients at time of scheduling that Aetna does not cover APD diagnosis or treatment services. (4) Update encounter forms and provider documentation templates to flag APD-related services as non-covered. (5) For patients already receiving APD services, notify them in writing that Aetna will not pay for ongoing or future APD-related treatments effective October 7, 2025, and they may be responsible for out-of-pocket costs. Failure to comply will result in improper claim submissions, denials, and potential compliance issues with Aetna.