Irreversible Electroporation (NanoKnife) — CPB 0828 | AETNA Coverage Update

Aetna modified CPB 0828 for irreversible electroporation (NanoKnife), effective March 4, 2026. Every indication remains non-covered. Here's what billing teams need to do.

Aetna, a CVS Health company, updated CPB 0828 — the Aetna irreversible electroporation coverage policy — on March 4, 2026. The policy covers CPT codes 0600T, 0601T, and 47384 for NanoKnife tissue ablation across 31 named tumor types. The verdict is the same as before: Aetna considers all IRE indications experimental, investigational, or unproven. If your team bills these codes for Aetna members, expect denial across the board.

Quick-Reference Table

Aetna Irreversible Electroporation Coverage Criteria and Medical Necessity Requirements 2026

Aetna does not cover NanoKnife for any clinical indication. The CPB 0828 Aetna coverage policy classifies all uses of irreversible electroporation as experimental, investigational, or unproven. That means there are no medical necessity criteria that unlock reimbursement here.

This is a blanket policy. It does not matter whether the clinical team believes IRE is the best option for a given patient. Aetna will not pay for it. There are no prior authorization pathways that result in approval — prior authorization review will end in denial for any indication on this list.

The policy applies to CPT 0600T (ablation, IRE, one or more tumors per organ, including imaging guidance), CPT 0601T (ablation, IRE, one or more tumors, with fluoroscopic and ultrasound guidance), and CPT 47384 (ablation, IRE, liver, one or more tumors, percutaneous). All three are explicitly listed as not covered for indications in CPB 0828.

The real issue here is that NanoKnife has been marketed aggressively to patients with difficult-to-treat tumors — especially pancreatic cancer. Patients often come in with strong expectations. Your billing team needs to set that expectation before the procedure happens, not after a claim denial lands in your AR.

Aetna NanoKnife Exclusions and Non-Covered Indications

Aetna's list of excluded indications is long. Thirty-one specific tumor types and cancer categories appear in CPB 0828. This is not a short exclusions list with a few carve-outs — it is the entire scope of clinical use for IRE.

The excluded indications include:

Aetna also specifically excludes combined IRE and nivolumab (J9299) for metastatic pancreatic ductal adenocarcinoma. That combination therapy has no coverage pathway under this policy.

The cardiac ablation carve-out deserves special attention. CPT codes 93650, 93655, and 93657 appear in the policy as "other related codes." These cover intracardiac catheter ablation procedures. If your cardiology team is using IRE-based pulsed field ablation for atrial fibrillation, this coverage policy is relevant — and the answer is still no.

Coverage Indications at a Glance

Aetna NanoKnife Billing Guidelines and Action Items 2026

The effective date of March 4, 2026, means this policy is already live. Here is what your billing team should do right now.

If you have a high volume of NanoKnife cases and significant Aetna patient mix, loop in your billing consultant and compliance officer before the end of the month. The financial exposure on these denials adds up fast.

CPT, HCPCS, and ICD-10 Codes for Irreversible Electroporation Under CPB 0828

Not Covered CPT Codes — All IRE Indications Under CPB 0828

Related HCPCS Code

Key ICD-10-CM Diagnosis Codes Referenced in CPB 0828

The policy references 264 ICD-10-CM codes in total. The representative codes below reflect the major cancer categories named in the policy:

All 264 ICD-10-CM codes in CPB 0828 are associated with non-covered indications under this policy. None unlock reimbursement for IRE procedures billed to Aetna.