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AetnaAll Plans · Coverage · Pharmacy · Neurology, Neurosurgery, OncologyMedium impact

Selected Techniques for Delivery of Drugs to the Brain (CPB 0731, reviewed 2026-10-21)

Effective date
Not stated in the notice
Identified
Oct 27, 2026

Summary

Aetna Clinical Policy Bulletin 0731 (last review 10/21/2026) states that convection-enhanced delivery of drugs into brain parenchyma and low-intensity MR-guided focused ultrasound mediated disruption of the blood-brain barrier for drug delivery are experimental, investigational, or unproven because their safety and effectiveness have not been established. The policy lists CPT 0947T and several ICD-10 codes, including those for malignant neoplasm of brain, Alzheimer's disease, and epilepsy, as not covered for the indications listed in the bulletin.

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What to do

Action · 2 steps
01REQUIREMENTS: Billing team: Review claims for CPT 0947T and the ICD-10 codes listed in the bulletin (C71.0 - C71.9, C79.31, C79.49, G30.0 - G30.9, G40.001 - G40.909, R56.1, R56.9) against the indications in the policy, because the policy lists them as not covered for the indications listed.
02Billing team: Note that the policy considers convection-enhanced delivery and low-intensity MRgFUS blood-brain barrier disruption for drug delivery experimental, investigational, or unproven, since their safety and effectiveness have not been established.

Codes mentioned

C71.0C71.9C79.31C79.49G30.0G30.9G40.001G40.909R56.1R56.9

Original notice

Selected Techniques for Delivery of Drugs to the Brain (CPB 0731, reviewed 2026-10-21)
aetna.com · Always check the source before changing claims.
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Related policy hubs

Aetna policiesNeurologyNeurosurgeryOncologyCode C71.0Code C71.9Code C79.31Code C79.49Code G30.0Code G30.9Code G40.001Code G40.909Code R56.1Code R56.9

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