Laser Photocoagulation of Drusen (CPB 0609, reviewed 2025-12-02)

Immediately: Billing team must update denial protocols and billing system software to automatically deny or route for manual review all claims for CPT 67220 (laser photocoagulation of drusen) when billed with any of the listed ICD-10 codes related to choroidal degeneration, age-related macular degeneration, or drusen. Verify that encounter forms and provider dashboards clearly flag this code as non-covered/experimental for these diagnoses. Add CPT 67220 to the non-covered procedure list for Aetna plans. Educate providers and front desk staff that prior authorization requests for this procedure will be denied. Any claims submitted will result in automatic denial; do not waste resources pursuing appeals without new clinical evidence of effectiveness.