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Bio-Surgery: Medicinal Leech Therapy and Medical Maggots (CPB 0556, reviewed 2025-12-02)
Effective date
Not stated in the notice
Identified
Aug 12, 2026
Summary
This is historical material: an older Aetna policy (source dated 2025-12-02) for medicinal leech therapy and medical maggots (CPB 0556) that PolicyChanges found recently, and it states no effective date. It lists leech therapy for venous congestion and flap or replant salvage, and maggot debridement for certain non-healing wounds, as medically necessary, and it names many other uses, including knee osteoarthritis, low back pain and hemorrhoids, as experimental.
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What to do
Action · 6 steps
01This is an older source with no stated effective date, so confirm current applicability with Aetna before acting on it.
02REQUIREMENTS: Providers and wound care staff, before ordering maggot therapy, document a non-healing necrotic wound of a listed type (chronic or neuropathic diabetic foot ulcer, non-healing traumatic or post-surgical wound, pressure ulcer, or venous stasis ulcer).
03Billing team, in charge entry, use CPT 97602 only with the wound diagnosis codes the source lists as covered, and flag burns and hand injuries complicated by mycotic infection before they go out, since the source lists them as not covered.
04Billing team, the source has no specific CPT code for medicinal leech therapy, so confirm the billing approach with Aetna before submitting.
05Billing team, flag leech therapy claims for the listed experimental uses, such as knee osteoarthritis, thumb osteoarthritis, epicondylitis, low back pain and hemorrhoids, before they go out.
06Front desk staff, tell providers that these experimental uses are not covered so they can discuss it with the patient before the visit.
Codes mentioned
97602I87.1I87.2I99.8B20G89.3L72.0Z21
Original notice
Bio-Surgery: Medicinal Leech Therapy and Medical Maggots (CPB 0556, reviewed 2025-12-02)
aetna.com · Always check the source before changing claims.
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