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AetnaAll Plans · Coverage · Pharmacy · Neurosurgery, Neurology, OncologyMedium impact

Selected Techniques for Delivery of Drugs to the Brain (CPB 0731, reviewed 2025-11-26)

Effective date
Not stated in the notice
Identified
Aug 16, 2026

Summary

Aetna considers convection-enhanced delivery of drugs into the brain parenchyma experimental, investigational, or unproven. Aetna also considers low-intensity MR-guided focused ultrasound (MRgFUS) mediated disruption of the blood-brain barrier for enhanced drug delivery into the brain experimental, because the safety and effectiveness of these approaches have not been established. CPT code 0947T for MRgFUS stereotactic blood-brain barrier disruption is not covered for the indications listed, and ICD-10 codes for brain malignancies, Alzheimer's disease, epilepsy and seizures are listed as not covered.

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What to do

Action · 3 steps
01Billing team: do not bill convection-enhanced delivery or low-intensity MRgFUS blood-brain barrier disruption for enhanced drug delivery as covered services, because the policy considers both experimental, investigational, or unproven.
02CPT 0947T is not covered for the indications listed.
03Claims for 0947T with ICD-10 codes C71.0 to C71.9, C79.31, C79.49, G30.0 to G30.9, G40.001 to G40.909, R56.1 or R56.9 will not be covered.

Codes mentioned

C71.0C71.9C79.31C79.49G30.0G30.9G40.001G40.909R56.1R56.9

Original notice

Selected Techniques for Delivery of Drugs to the Brain (CPB 0731, reviewed 2025-11-26)
aetna.com · Always check the source before changing claims.
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Related policy hubs

Aetna policiesNeurosurgeryNeurologyOncologyCode C71.0Code C71.9Code C79.31Code C79.49Code G30.0Code G30.9Code G40.001Code G40.909Code R56.1Code R56.9

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