CommercialCoverageHigh impact
Computerized Motion Diagnostic Imaging (CPB 0432, reviewed 2026-07-09)
Aetna·Chiropractic, Physical Therapy, PM&R (Physical Medicine & Rehab) +2 more·Radiology
Effective date
Jul 9, 2026
We identified it
Aug 15, 2026
Summary
Aetna updated CPB 0432 to classify computerized motion diagnostic imaging (CMDI), DARI scans, and vertebral motion analysis as experimental, investigational, or unproven for all indications including spine evaluation. Billing teams must deny claims for CPT codes 0693T, 96000, 96001, and 96004 when billed for these procedures, and reject associated ICD-10 codes M99.00-M99.09, M99.10-M99.19, and M99.20-M99.29 for coverage under this policy.
Action Required
By July 9, 2026: Billing team must update claims processing system to automatically deny all claims for CPT codes 0693T, 96000, 96001, and 96004 when submitted under Aetna commercial plans. Configure system to reject claims pairing these codes with ICD-10 codes M99.00-M99.09 (segmental/somatic dysfunction), M99.10-M99.19 (subluxation complex), and M99.20-M99.29 (subluxation stenosis) as non-covered experimental procedures. Update billing software rejection reason to reference CPB 0432 and indicate experimental/investigational status. Notify in-network providers (especially chiropractors, physical medicine specialists, and orthopedic practices) of denial criteria. Implement hard stop in billing system to prevent submission of these code combinations. Failure to implement will result in claim denials post-adjudication and potential overpayment recovery.