CommercialCoverageLow impact
Intragastric Hypothermia (CPB 0527, reviewed 2026-07-30)
Aetna·Gastroenterology, General Surgery, Internal Medicine·Medical Policy
Effective date
Jun 15, 2001
We identified it
Aug 16, 2026
Summary
Aetna has confirmed that intragastric hypothermia (gastric freezing) remains non-covered as experimental and unproven for chronic peptic ulcer disease and all other indications. HCPCS code M0100 and ICD-10 codes K27.4-K27.9 are not covered. Billing teams must ensure claims for this procedure are denied and do not process reimbursement.
Action Required
Immediately: Billing team must verify that claims containing HCPCS code M0100 (Intragastric hypothermia using gastric freezing) paired with ICD-10 codes K27.4-K27.9 are configured to auto-deny in the billing system without processing payment. Add a system rule to flag any M0100 claims as non-covered. Notify providers that this procedure remains experimental and unproven per Aetna policy. No prior authorization is needed—claims should be systematically rejected. Ensure denial notices are sent to patients and providers explaining the non-covered status.