CommercialCoverageMedium impact
Endolymphatic Hydrops (Meniere's Disease) Tests (CPB 0571, reviewed 2025-12-02)
Aetna·ENT (Ear, Nose & Throat), Audiology, Neurology·Medical Policy
Effective date
Dec 2, 2025
We identified it
Aug 14, 2026
Summary
Aetna updated its policy on Meniere's disease diagnostic testing, narrowing coverage for dehydration testing (with glycerol, urea, or osmotic diuretics) to only atypical presentations while classifying most advanced diagnostic tests as experimental/investigational. Multiple specific tests including genetic testing, gadolinium MRI, VEMP testing, and multi-frequency tympanometry are now not covered for Meniere's disease diagnosis.
Action Required
By December 2, 2025: Billing team must implement denial logic in claims processing system for the following codes when billed for Meniere's disease (ICD-10: H81.01-H81.09): CPT 92517, 92518, 92519 (VEMP testing), CPT 92550, 92567 (multi-frequency tympanometry), CPT 92584 (electrocochleography per related policy), CPT 81406 (genetic testing for KCNE1, KCNE3, SIK1, SLC8A1, SLC26A4 mutations), and HCPCS A9579 (gadolinium contrast). Update billing software to flag dehydration testing claims without documentation of atypical presentation for manual review. Notify ENT and neurology providers of coverage restrictions. Providers must document 'atypical presentation' in medical record if billing dehydration testing to avoid claim denials. Claims submitted without proper documentation or for non-atypical cases will be denied as experimental/investigational.