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Laser Neurolysis (CPB 0552, reviewed 2026-08-03)

Aetna·Neurology, Neurosurgery, Pain Management +3 more·Medical Policy
Effective date
Aug 3, 2026
We identified it
Aug 18, 2026
Days to comply

Summary

Aetna has classified laser neurolysis (laser peripheral nerve block) as experimental, investigational, or unproven for five specific indications: carpal tunnel syndrome, complex regional pain syndrome, facet joint pain, phantom limb pain, and sacroiliac joint pain. This means claims for laser neurolysis procedures targeting these conditions will not be covered by Aetna, effective immediately as of the policy review date of August 3, 2026.

Action Required

Action needed
Effective immediately (August 3, 2026): Billing team must update the billing system to deny or reject all claims for laser neurolysis procedures (CPT codes 64600, 64610, 64620, 64640, 64702, 64704, 64708, 64714, 64727) when billed with ICD-10 diagnosis codes for carpal tunnel syndrome (G56.00-G56.03), complex regional pain syndrome (G56.40-G56.42, G57.70-G57.73, G90.50-G90.59), facet joint pain (M53.0, M53.82-M53.83), phantom limb pain (G54.6), or sacroiliac joint pain (M53.3). Update billing software to flag these code combinations as non-covered. Providers must be notified that laser neurolysis for these five indications is no longer a covered benefit under Aetna plans. Implement denial messaging in claims processing system and ensure front-end verification processes screen for these combinations. Any claims submitted for these code-diagnosis combinations will be denied as experimental/investigational.

Affected Billing Codes

64600
64610
64620
64640
64702
64704
64708
64714
64727
G54.6
G56.00
G56.01
G56.02
G56.03
G56.40
G56.41
G56.42
G57.70
G57.71
G57.72
G57.73
G90.50
G90.51
G90.52
G90.53
G90.59
M53.0
M53.3
M53.82
M53.83
M54.2
M54.50
M54.51
M54.52
M54.53
M54.54
M54.55
M54.56
M54.57
M54.58
M54.59
M54.6