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Ultra Rapid Detoxification (UROD) (CPB 0317, reviewed 2026-05-21)

Aetna·Psychiatry, Anesthesiology, Internal Medicine·Medical Policy
Effective date
May 21, 2026
We identified it
Aug 18, 2026
Days to comply

Summary

Aetna has classified Ultra Rapid Detoxification (UROD) as experimental, investigational, or unproven and will not cover this procedure for opioid use disorder treatment or any other indication. There is no specific CPT code for UROD itself, but related naloxone injection codes (J2312, J2313) and opioid-related ICD-10 codes are identified as non-covered when billed for UROD indications. This is a coverage denial policy effective immediately.

Action Required

Action needed
Effective immediately (as of May 21, 2026): Billing and prior authorization teams must deny all claims for Ultra Rapid Detoxification (UROD) procedures as experimental/unproven under Aetna plans. If claims for UROD are submitted with CPT codes related to anesthesia, procedures, or facility services in combination with naloxone codes (J2312, J2313) and opioid-related ICD-10 codes (F11.10-F11.29, T40.0X1-T40.695), flag and deny as non-covered. Update internal billing guidelines and prior authorization protocols to reflect UROD non-coverage. Train billing staff to recognize UROD-related claim submissions and apply the non-coverage determination. Notify providers in-network that Aetna will not authorize or pay for UROD procedures. No prior authorization will be granted for this procedure. Claims submitted after this date without recognition of the non-coverage policy may delay denials.

Affected Billing Codes

J2312
J2313
F11.10
F11.11
F11.12
F11.13
F11.14
F11.15
F11.16
F11.17
F11.18
F11.19
F11.20
F11.21
F11.22
F11.23
F11.24
F11.25
F11.26
F11.27
F11.28
F11.29
T40.0X1
T40.0X2
T40.0X3
T40.0X4
T40.0X5
T40.1X1
T40.1X2
T40.1X3
T40.1X4
T40.2X1
T40.2X2
T40.2X3
T40.2X4
T40.2X5
T40.3X1
T40.3X2
T40.3X3
T40.3X4
T40.3X5
T40.4X1
T40.4X2
T40.4X3
T40.4X4
T40.4X5
T40.601
T40.602
T40.603
T40.604
T40.605
T40.691
T40.692
T40.693
T40.694
T40.695