Medicare AdvantageCoverageMedium impact
Renal Sympathetic Nerve Ablation (CPB 0847, reviewed 2025-12-18)
Aetna·Cardiology, Nephrology, Internal Medicine +2 more·Surgery
Effective date
Dec 18, 2025
We identified it
Aug 15, 2026
Summary
Aetna has classified renal sympathetic nerve ablation (radiofrequency, microwave, ultrasound, transurethral, and cryoablation methods) as experimental, investigational, or unproven for multiple indications including hypertension, heart failure, chronic kidney disease, cardiac arrhythmias, and obstructive sleep apnea. This policy effective 2025-12-18 designates specific CPT codes (0338T, 0339T, 0935T) and associated ICD-10 codes as non-covered when billed with these listed indications, requiring denial of claims.
Action Required
Effective immediately (2025-12-18): Billing team must update claim edits in billing system to deny CPT codes 0338T, 0339T, and 0935T when submitted with any of the listed ICD-10 diagnosis codes (hypertension I10-I16.9, cardiac arrhythmias I47-I49.9, myocardial infarction I21.01-I21.4, heart failure, chronic kidney disease N18.1-N18.9, obstructive sleep apnea G47.33, and chronic kidney-related pain G89.29 or N23). Providers should be notified that renal sympathetic nerve ablation procedures are considered experimental/investigational for these indications and will not be covered. Update encounter documentation templates to flag these procedure codes when paired with excluded diagnoses. Implement system validation rules to require prior authorization review before claims are submitted; claims without documented medical necessity exceptions will be denied. Front desk staff must communicate to patients that these procedures are not covered benefits under their Aetna plan for these conditions.