CommercialCoverageMedium impact
Pedobarography (CPB 0294, reviewed 2026-04-17)
Aetna·Podiatry, Orthopedics, Sports Medicine +5 more·Medical Policy
Effective date
Apr 17, 2026
We identified it
Aug 13, 2026
Summary
Aetna has classified pedobarography (foot pressure studies) as experimental, investigational, or unproven and will not cover CPT 96001 (comprehensive computer-based motion analysis with dynamic plantar pressure measurements). This policy applies to all listed ICD-10 diagnoses including diabetic neuropathy, varicose veins, pressure ulcers, and osteoarthritis. Billing teams must deny or refuse to bill pedobarography claims under Aetna plans effective immediately.
Action Required
Effective 2026-04-17: Billing team must implement the following: (1) Update billing system to flag CPT 96001 as non-covered (experimental/investigational) for all Aetna plans; (2) Do not bill CPT 96001 when paired with any of the listed ICD-10 diagnosis codes (diabetic neuropathy E10.40-E11.49, autonomic neuropathy G99.0, varicose veins I83.001-I83.229, pressure ulcers L89.500-L89.899, osteoarthritis M19.071-M19.279, scoliosis M41.00-M41.9, or orthotic fitting codes Z46.89, Z47.81-Z47.89); (3) Notify providers and clinical staff that pedobarography is no longer a billable/covered service under Aetna; (4) Update encounter templates and order entry systems to remove pedobarography as an available option for Aetna patients; (5) If claims are submitted, expect denials with remittance reason 'experimental/investigational procedure.' Proactively reach out to providers who frequently order pedobarography (orthopaedic surgeons, physiatrists, podiatrists) to prevent claim denials and patient balance billing.