CommercialCoverageMedium impact
Huntington's Disease (CPB 0614, reviewed 2026-09-24)
Aetna·Neurology, Neurosurgery, Psychiatry +3 more·Medical Policy
We identified it
Oct 2, 2026
Summary
Aetna has updated its Huntington's Disease clinical policy (CPB 0614) to designate numerous diagnostic biomarkers, imaging modalities, and treatment interventions as experimental, investigational, or unproven. This policy clarifies that services including gene therapy, stem cell transplantation, deep brain stimulation, transcranial magnetic stimulation, advanced neuroimaging, and various biomarker tests are not covered. Billing teams must deny or obtain prior authorization denials for any claims using the listed CPT codes when billed for Huntington's disease indications.
Action Required
Immediately: Billing team must implement denial logic in the billing system for all listed CPT codes when submitted with Huntington's disease diagnoses (ICD-10 code G10) under Aetna plans. Create a claims review checklist identifying the 45+ affected codes and ensure staff flag claims for manual review before transmission. Update claim denial templates to reference CPB 0614 and specify that these services are considered experimental/investigational. Providers should be notified via internal communication that claims for gene therapy, stem cell transplantation, DBS, TMS, advanced neuroimaging, and biomarker testing for Huntington's disease will be denied. Route any appeals to the clinical review team. Do not bill these codes for Huntington's disease patients without explicit prior authorization from Aetna's medical policy department, as denials will result.