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Oral and Esophageal Brush Biopsy (CPB 0686, reviewed 2026-10-15)
Effective date
Not stated in the notice
Identified
Oct 23, 2026
Summary
Aetna Clinical Policy Bulletin 0686 on oral and esophageal brush biopsy was last reviewed on 10/15/2026. It considers oral brush biopsy (OralCDx) with or without MAGE-A or GLUT-1 staining, esophageal brush biopsy (WATS3D, formerly EndoCDx), DNA-image cytometry, RNA-based oral brush biopsy, salivary miRNAs and esophageal balloon cytologic sampling experimental, investigational or unproven because their effectiveness has not been established, for screening, diagnosis or surveillance. The policy lists CPT 88104 and 99000, HCPCS D0486 and D7288, and several ICD-10 codes, including Z12.81, as not covered for the indications it lists.
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What to do
Action · 3 steps
01Billing team: the policy considers oral brush biopsy, esophageal brush biopsy (WATS3D), DNA-image cytometry, RNA-based oral brush biopsy, salivary miRNAs and the esophageal balloon experimental, investigational or unproven.
02Claims for CPT 88104 and 99000, HCPCS D0486 and D7288, and the listed ICD-10 codes are not covered for the indications listed in the policy.
03The policy states there is no specific CPT code for RNA-based oral brush biopsy, the esophageal balloon or salivary miRNAs.
Codes mentioned
8810499000D0486D7288C10.0C10.9D00.00D00.08D10.0D11.9D37.01D37.02D37.04D37.09K09.1K09.9K12.0K13.79K14.0K14.9Z12.81
Original notice
Oral and Esophageal Brush Biopsy (CPB 0686, reviewed 2026-10-15)
aetna.com · Always check the source before changing claims.
Related changes
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