CommercialCoverageHigh impact
Stereolithographic Models and Implants (CPB 0613, reviewed 2026-09-03)
Aetna·Cardiothoracic Surgery, Plastic Surgery, General Surgery +3 more·Surgery
We identified it
Oct 4, 2026
Summary
Aetna's updated Clinical Policy Bulletin 0613 (effective 2026-09-03) classifies 3D stereolithographic models and implants as experimental and investigational across cardiac surgery, plastic/reconstructive surgery, penile brachytherapy, cranial implants, and pre-operative planning applications. CPT codes 0559T, 0560T, 0561T, and 0562T are NOT covered for these indications, and claims using these codes for listed procedures will be denied.
Action Required
Immediately: Billing team must update all Aetna claim submission systems to deny or flag for manual review any claims containing CPT codes 0559T, 0560T, 0561T, or 0562T when billed with cardiac surgery, plastic/reconstructive surgery, penile brachytherapy, cranial implant, or pre-operative planning procedures. Update claim edits in billing software to include denial reason: 'Stereolithographic models are experimental/investigational per Aetna CPB 0613.' Providers must be notified that these services are not covered and patients should be given advance notice of non-coverage and financial responsibility. Do not submit these claims to Aetna; educate providers and front desk staff immediately on this policy to prevent claim denials and patient billing disputes.