Aetna modified CPB 0392 for metabolic and environmental profiling for kidney stone risk, effective January 11, 2026. Here's what billing teams need to know.

Aetna, a CVS Health company, updated its kidney stone risk assessment coverage policy under CPB 0392 Aetna system to explicitly classify several diagnostic approaches as experimental, investigational, or unproven. The policy covers 17 CPT codes — including imaging codes 72192–72197, laboratory codes 82340–84560, and the newly added Category III code 0991T for acoustic enhancer microbubble cavitation lithotripsy. If your practice handles urology, nephrology, or related metabolic lab work, this update changes what you can bill and expect reimbursement on.


Quick-Reference Table

Field Detail
Payer Aetna, a CVS Health company
Policy Metabolic and Environmental Profiling for Kidney Stone Risk
Policy Code CPB 0392
Change Type Modified
Effective Date January 11, 2026
Impact Level Medium-High
Specialties Affected Urology, Nephrology, Radiology, Clinical Laboratory
Key Action Audit claims for CPT 0991T, 72192–72197, and any genetic/molecular analysis codes before submitting to Aetna

Aetna Kidney Stone Risk Assessment Coverage Criteria and Medical Necessity Requirements 2026

The Aetna kidney stone profiling coverage policy draws a hard line between supported metabolic testing and techniques the payer considers unproven. Understanding that line is where you avoid a claim denial.

Metabolic urine testing — the established workup for recurrent stone formers — remains covered when medical necessity criteria are met. This includes the core 24-hour urine panel: calcium (CPT 82340), citrate (82507), creatinine (82570), oxalate (83945), pH (83986), phosphorus (84105), urea nitrogen (84540 and 84545), and uric acid (84560). These codes appear in the "other CPT codes related to this CPB" group, which signals covered status under appropriate clinical indications.

The medical necessity standard for this panel is what you'd expect: documented recurrent urolithiasis, an ICD-10 of N20.0 (calculus of kidney), or a relevant history code like Z87.442 (personal history of urinary calculi). Without one of those anchors on the claim, expect a medical necessity denial. If your documentation doesn't support recurrent stone disease, the urine chemistry panel won't hold up on appeal either.

The policy does not specifically list prior authorization requirements for the laboratory panel. That said, Aetna plan benefits vary — particularly for high-cost outpatient lab orders. If your billing team is submitting these codes for a commercial Aetna plan with a carved-out lab benefit, verify prior authorization requirements at the plan level before the effective date. Don't assume the policy silence means the plan is silent.


Aetna Kidney Stone Risk Assessment Exclusions and Non-Covered Indications

This is where the January 11, 2026 update has real teeth. Four categories are now explicitly classified as experimental, investigational, or unproven.

1. Acoustic enhancer microbubble cavitation (AEMC) lithotripsy — CPT 0991T

This is the biggest billing flag in the update. CPT 0991T covers cystourethroscopy with low-energy lithotripsy using acoustically actuated microspheres. The technology, marketed under the Enhanced Lithotripsy System (ELS) by Avvio Medical, gets a hard non-covered designation. Aetna cites a lack of evidence to support its effectiveness. If you bill 0991T to Aetna, the claim will not pay. Full stop.

2. CT and MRI for urolithiasis screening of asymptomatic persons — CPT 72192–72197

This one is narrower than it sounds. The exclusion is specifically for asymptomatic screening. CT imaging (72192, 72193, 72194) and MRI of the pelvis (72195, 72196, 72197) for an asymptomatic patient without prior stone history or active symptoms are not covered. The clinical rationale is lack of evidence for this screening indication.

CT for a symptomatic patient presenting with flank pain or known urolithiasis is a different situation — that's diagnostic, not screening. But your documentation has to support that distinction. Billing 72192 with a vague "kidney stone evaluation" note and no documented symptomatology is the kind of thing that triggers a medical necessity denial on audit.

3. Calcifying nanoparticles for kidney stone risk assessment

No CPT code is listed for this. There's no established billing pathway for this technology under Aetna. Don't bill it.

4. Genetic and molecular analysis for kidney stone risk

Aetna explicitly excludes genetic or molecular analysis for assessing kidney stone risk. No CPT code is listed in this update for that category — but if your lab is running gene panels or molecular markers as part of a stone risk workup and billing them to Aetna, this policy puts you on notice. Those services are not covered. If your genetics or molecular pathology team runs these under a broader panel CPT, talk to your compliance officer about whether any component falls under this exclusion before the next billing cycle.


Coverage Indications at a Glance

Indication Status Relevant Codes Notes
Metabolic urine profiling for recurrent kidney stone risk Covered (when medically necessary) 82340, 82507, 82570, 82615, 83945, 83986, 84105, 84540, 84545, 84560 Requires documented stone history; link to N20.0 or Z87.442
CT of pelvis for symptomatic urolithiasis Covered (implied — not excluded) 72192, 72193, 72194 Exclusion applies only to asymptomatic screening; document symptoms clearly
MRI of pelvis for symptomatic urolithiasis Covered (implied — not excluded) 72195, 72196, 72197 Same documentation standard as CT — symptoms must be documented
+ 4 more indications

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This policy is now in effect (since 2026-01-11). Verify your claims match the updated criteria above.

Aetna Kidney Stone Profiling Billing Guidelines and Action Items 2026

#Action Item
1

Pull every claim submitted with CPT 0991T before January 11, 2026. If any are pending with Aetna, withdraw them now. If any paid, your compliance officer needs to know — Aetna may recoup. This code is not covered, and submitting it after the effective date means a guaranteed denial.

2

Audit your imaging documentation for CPT 72192–72197. The exclusion targets asymptomatic screening specifically. Before submitting any pelvic CT or MRI to Aetna for kidney stone-related billing, confirm your documentation includes the presenting symptom — flank pain, hematuria, acute colic — not just a diagnostic impression. Asymptomatic screening claims will not survive a medical necessity review.

3

Verify diagnosis codes on all urine chemistry panel claims. The covered lab panel (82340, 82507, 82570, 82615, 83945, 83986, 84105, 84540, 84545, 84560) needs a supported diagnosis. N20.0 for calculus of kidney and Z87.442 for personal history of urinary calculi are your primary ICD-10 anchors. R82.991 through R82.998 for abnormal urine findings can also support coverage — but those are secondary to a documented clinical picture. Don't rely on them alone.

+ 3 more action items

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Sample Version Diff Line-by-line changes
Previous VersionCurrent Version
Coverage is considered experimental and investigational for all indicationsCoverage is considered medically necessary when specific criteria are met
Prior authorization is not requiredPrior authorization is required for initial treatment
Documentation must include clinical historyDocumentation must include clinical history
+ 1 more action items

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CPT, HCPCS, and ICD-10 Codes for Kidney Stone Risk Profiling Under CPB 0392

Not Covered / Experimental CPT Codes

Code Type Description Reason
0991T CPT Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging Experimental — AEMC lithotripsy not covered for any indication
72192 CPT Computed tomography, pelvis; without contrast material Not covered for asymptomatic urolithiasis screening
72193 CPT Computed tomography, pelvis; with contrast material(s) Not covered for asymptomatic urolithiasis screening
+ 4 more codes

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Covered CPT Codes — Metabolic Urine Profiling (When Medical Necessity Is Met)

Code Type Description
82340 CPT Calcium; urine quantitative, timed specimen
82507 CPT Citrate
82570 CPT Creatinine; other source
+ 7 more codes

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Key ICD-10-CM Diagnosis Codes

Code Description
N20.0 Calculus of kidney
R82.991 Other abnormal findings in urine
R82.992 Other abnormal findings in urine
+ 7 more codes

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