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AetnaCommercial · Coverage · Medical Policy · Gastroenterology, Urology, Pulmonology +3 moreMedium impact

In Vivo Analysis of Gastro-Intestinal and Urothelial Lesions (CPB 0783, reviewed 2026-10-27)

Effective date
Not stated in the notice
Identified
Nov 7, 2026

Previous versions

Summary

Aetna's Clinical Policy Bulletin 0783 (reviewed 2026-10-27) confirms that in vivo analysis technologies for gastrointestinal and urothelial lesions, including confocal laser endomicroscopy, narrow-band imaging, chromoendoscopy and optical biopsy systems, are considered experimental, investigational or unproven for the listed indications. Claims for these services with the listed CPT codes (such as 43206, 43252 and +0397T) and ICD-10 diagnoses will be denied under this policy, so billing staff should review how these services are coded and documented before submission.

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What to do

Action · 3 steps
01Billing team: Review the Aetna CPB 0783 list of experimental indications and check charge entry for CPT 43206, 43252, +0397T and related optical-analysis services before claim submission.
02For listed indications, confirm the service is documented as medically necessary under another covered code or stop scheduling the optical-analysis component for Aetna members and inform providers and front desk staff.
03Claims for these services without supporting documentation will be denied under this policy; the source does not state an effective date, so confirm current applicability with Aetna.

Codes mentioned

432064325245378G0105G0121B65.0C15.3C34.00C67.0K22.710K50.00K51.00K63.5Z12.11Z86.0100

Original notice

In Vivo Analysis of Gastro-Intestinal and Urothelial Lesions (CPB 0783, reviewed 2026-10-27)
aetna.com · Always check the source before changing claims.
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Related changes

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Related policy hubs

Aetna policiesGastroenterologyUrologyPulmonologyOncologyENT (Ear, Nose & Throat)PathologyCode 43206Code 43252Code 45378Code G0105Code G0121Code B65.0Code C15.3Code C34.00Code C67.0Code K22.710Code K50.00Code K51.00Code K63.5Code Z12.11Code Z86.0100

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