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Chemical Aversive Conditioning for Alcoholism (CPB 0896, reviewed 2025-12-22)

Aetna·Psychiatry, Internal Medicine, Family Medicine·Medical Policy
Effective date
Not stated
We identified it
Aug 15, 2026
Days to comply

Summary

Aetna has reaffirmed that chemical aversive conditioning for alcoholism is considered experimental, investigational, or unproven and is not covered. This policy (CPB 0896) was reviewed on 2025-12-22 and applies to all treatment involving chemical agents (emetine, apomorphine, lithium) paired with alcohol to create conditioned aversions. Billing teams must deny claims for this service across all applicable ICD-10 codes (F10.10-F10.19 for alcohol abuse; F10.20-F10.29 for alcohol dependence).

Action Required

Action needed
Billing team: Immediately ensure that any claims submitted for chemical aversive conditioning therapy (using emetine, apomorphine, or lithium with alcohol as treatment for alcoholism) are denied with reason code for experimental/investigational/unproven service. No CPT code exists for this service in current billing systems. When claims arrive with ICD-10 codes F10.10-F10.29 indicating alcoholism treatment, verify the procedure is not chemical aversive conditioning before processing. If chemical aversive conditioning is documented, issue denial notice to provider and patient indicating non-covered experimental treatment. Update denial templates and staff education materials to reference CPB 0896. No prior authorization process is required as the service is not covered under any circumstances.

Affected Billing Codes

F10.10
F10.11
F10.12
F10.13
F10.14
F10.15
F10.16
F10.17
F10.18
F10.19
F10.20
F10.21
F10.22
F10.23
F10.24
F10.25
F10.26
F10.27
F10.28
F10.29