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Scrotal Ultrasonography (CPB 0532, reviewed 2026-07-29)
Effective date
Not stated in the notice
Identified
Aug 16, 2026
Summary
Aetna considers scrotal ultrasonography (CPT 76870) medically necessary for scrotal mass lesions or tumors, undescended testes in the situations the policy lists, suspected testicular torsion, hydroceles, evaluation of infertile men, acute scrotal pain or swelling, scrotal injury or trauma, and varicoceles. Aetna considers it experimental, investigational, or unproven for other indications, including the initial evaluation for infertility unless physical examination of the scrotum is difficult or inadequate or a testicular mass is suspected, and surveillance of testicular microlithiasis in the absence of additional risk factors.
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What to do
Action · 4 steps
01Billing team: Bill CPT 76870 with the covered ICD-10 codes listed in the policy, such as C63.2, D29.4, D40.10 to D40.12, I86.1, N50.82 and Q55.22, when the selection criteria are met.
02Billing team: Do not bill Z31.41 or Z31.49 for the initial evaluation for infertility unless physical examination of the scrotum is difficult or inadequate or a testicular mass is suspected.
03Billing team: Do not bill scrotal ultrasonography for surveillance of testicular microlithiasis in the absence of additional risk factors, because the policy considers it experimental, investigational, or unproven.
04Billing team: Note that testicular microlithiasis is not covered under N50.82.
Codes mentioned
76870C63.2D29.4D40.10D40.12I86.1N43.0N43.42N44.00N44.04N45.1N45.4N46.01N46.9N50.0N50.811N50.819N50.82P83.5Q53.00Q53.9Q55.22Q55.23R39.83R39.84S39.848S39.94XZ31.41Z31.49
Original notice
Scrotal Ultrasonography (CPB 0532, reviewed 2026-07-29)
aetna.com · Always check the source before changing claims.
Related changes
See all Aetna changes →Vasectomy Procedures and Chronic Scrotal Content Pain (CPB 0027, reviewed 2026-01-27)MediumNo effective date · Medical PolicyTransrectal Ultrasound (CPB 0001, reviewed 2026-03-05)MediumNo effective date · RadiologyPulsed Radiofrequency (CPB 0735, reviewed 2026-10-21)MediumNo effective date · Medical PolicyHuman Chorionic Gonadotropin (hCG) (CPB 1081, reviewed 2026-10-08)MediumEffective Aug 12, 2025 · Medical PolicyBrowse every Aetna change in the policy list
Related policy hubs
Aetna policiesUrologyPediatricsRadiologyCode 76870Code C63.2Code D29.4Code D40.10Code D40.12Code I86.1Code N43.0Code N43.42Code N44.00Code N44.04Code N45.1Code N45.4Code N46.01Code N46.9Code N50.0Code N50.811Code N50.819Code N50.82Code P83.5Code Q53.00Code Q53.9Code Q55.22Code Q55.23Code R39.83Code R39.84Code S39.848Code S39.94XCode Z31.41Code Z31.49