CommercialCoverageHigh impact
Wound Imaging and Noninvasive Wound Therapy (CPB 0372, reviewed 2026-05-21)
Aetna·Wound Care, Radiology, General Surgery +4 more·Radiology
Effective date
May 21, 2026
We identified it
Aug 19, 2026
Summary
Aetna has designated multiple wound imaging and noncontact wound therapy procedures as experimental, investigational, or unproven, effective immediately. Billing teams must deny or obtain prior authorization for CPT codes 0061U, 0598T, 0599T, 0906T, 0907T, 0972T, 97610, and HCPCS codes A6000, E0231, E0232 when billed for wound care indications. These services are no longer covered under this policy.
Action Required
IMMEDIATE (Effective 2026-05-21): Billing team must update claim submission rules in billing software to flag or deny the following codes when submitted for Aetna patients: CPT 0061U, 0598T, 0599T, 0906T, 0907T, 0972T, 97610 and HCPCS A6000, E0231, E0232. Providers must be notified that these procedures are now classified as experimental/investigational and will not be covered. Update encounter forms and clinical documentation templates to reflect non-coverage status. Implement system rules to require manual review or prior authorization denial before claims are submitted. Consequences: Claims submitted without prior denial review will be rejected by Aetna, resulting in patient balance responsibility and claim rework.