By 2026-07-29: Billing team must update claim submission protocols to enforce Aetna's specific medical necessity criteria for radiofrequency ablation procedures. (1) COVERED INDICATIONS: Configure billing system to allow claims only when diagnosis codes and clinical documentation support one of the listed approved indications (e.g., solitary HCC ≤5cm, renal cell carcinoma ≤4cm in high-risk patients, adrenocortical carcinoma, benign thyroid nodules >2cm). (2) NOT COVERED/EXPERIMENTAL: Block or flag for review any claims for CPT 47370, 47380, 47382, 32998, 50592, and related codes when paired with non-covered diagnosis codes, including: biliary obstructions (K83.1), pancreatic cancer/neoplasms (C25.x, D13.2, D13.6, D01.7), renal cysts (N28.1, Q61.x), adrenal metastases from primary tumors other than adrenocortical carcinoma, breast cancer, esophageal cancer, gallbladder cancer, pancreatic neuroendocrine tumors, spinal metastases, or thymoma. (3) REQUIRE DOCUMENTATION: Providers must document that patients meet specific criteria (e.g., high-risk surgical candidate status, GFR ≤60 ml/min/m², solitary kidney status, size limitations). (4) PRIOR AUTHORIZATION: Implement pre-authorization protocol for all RFA procedures; do not submit claims for experimental combinations (e.g., RFA + trans-arterial chemoembolization, RFA + vertebral cement augmentation, ERCP + pancreatoscopy + RFA). Failure to comply will result in claim denials. Update encounter forms and provider alerts to reinforce approved indications.