Magnetic Resonance Neurography — CPB 0387 | AETNA Coverage Update

Aetna modified CPB 0387 covering magnetic resonance neurography, effective September 26, 2025. Here's what billing teams need to know.

Aetna, a CVS Health company, updated its Aetna magnetic resonance neurography coverage policy under CPB 0387 in the CBP 0387 Aetna system. The policy governs coverage for MR neurography — a specialized MRI technique used to image peripheral nerves — and applies across nerve, nerve root, and plexus disorders (ICD-10 G50.0–G59) and nerve injury diagnoses spanning cranial, spinal, and peripheral injury codes. If your practice bills MR neurography for neurology, orthopedic, or spine patients with Aetna commercial plans, this policy directly affects your reimbursement and claim denial risk.

Quick-Reference Table

Aetna Magnetic Resonance Neurography Coverage Criteria and Medical Necessity Requirements 2025

The central question your billing team faces with any MR neurography claim is medical necessity. Aetna's coverage policy under CPB 0387 requires that the procedure be medically necessary — meaning the clinical documentation must support the use of MR neurography over standard MRI. That distinction matters. Standard MRI of the spine or extremity has established coverage pathways. MR neurography is a targeted, nerve-specific imaging technique, and Aetna treats it differently.

The ICD-10 diagnoses tied to this policy fall into two clear groups. The first is nerve, nerve root, and plexus disorders under G50.0 through G59. This range covers conditions like trigeminal neuralgia, facial nerve disorders, brachial neuritis, lumbosacral plexus disorders, and mononeuropathies of the upper and lower limbs. The second group is traumatic nerve and spinal cord injuries — a broad set of S-codes covering cranial nerve injuries (S04), cervical spinal cord injuries (S14), thoracic (S24), lumbar and sacral (S34), and peripheral nerve injuries at the shoulder (S44), elbow (S54), wrist and hand (S64), hip (S74), knee and leg (S84), and ankle and foot (S94) levels.

Your documentation needs to map to one of these categories. If the physician's notes describe nerve compression or peripheral nerve injury without a supporting ICD-10 from these ranges, Aetna has grounds to deny the claim on medical necessity.

Prior authorization requirements for MR neurography under Aetna's commercial plans vary by specific plan and market. Don't assume prior auth isn't required because the policy doesn't mandate it universally. Check the member's benefits before scheduling. A missing prior authorization on an advanced imaging service is one of the fastest routes to a claim denial that's genuinely hard to appeal.

Aetna Magnetic Resonance Neurography Exclusions and Non-Covered Indications

The policy data published with this modification does not enumerate a specific list of experimental or non-covered indications within the CPB 0387 update itself. That's not a green light for open billing.

Aetna's broader clinical policy framework consistently treats unproven applications of advanced imaging as not covered. If MR neurography is ordered for a condition that standard imaging already addresses — or where the clinical evidence doesn't support nerve-specific imaging — expect a medical necessity denial. The ICD-10 ranges in the policy are the clearest signal of where Aetna draws the line.

If your practice is using MR neurography for indications outside G50.0–G59 or the listed S-code ranges, flag those cases with your compliance officer before September 26, 2025. Claims billed under the updated policy without supporting diagnoses in these ranges carry real financial exposure.

Coverage Indications at a Glance

Aetna Magnetic Resonance Neurography Billing Guidelines and Action Items 2025

Good magnetic resonance neurography billing starts with diagnosis code precision. Here's what your team needs to do before and after the September 26, 2025 effective date.

CPT, HCPCS, and ICD-10 Codes for Magnetic Resonance Neurography Under CPB 0387

The policy data published with this modification does not list specific CPT or HCPCS procedure codes. This is not uncommon for Aetna's Clinical Policy Bulletins — the CPB framework sometimes addresses clinical and medical necessity criteria at the diagnosis level without enumerating specific procedure codes within the published document. Your coding team should reference the current AMA CPT code set for MR neurography procedure codes and confirm Aetna's fee schedule applicability separately.

Key ICD-10-CM Diagnosis Codes

The ICD-10 ranges above represent the full scope of diagnoses Aetna recognizes under CPB 0387. Bill MR neurography against codes outside these ranges at your own risk — the claim denial rate will be high, and the appeal pathway narrow without strong clinical documentation.

One important note: the S-code ranges in this policy are unusually broad. They span every peripheral nerve injury site from the shoulder to the foot and include all encounter types through sequela. That breadth is useful for post-traumatic peripheral neuropathy cases. But it also means your coders need to assign the correct seventh-character extension every time — A for initial encounter, D for subsequent encounter, S for sequela. A wrong character means a rejected claim, not just a denial.