Interstitial Laser Therapy — CPB 0781 | AETNA Coverage Update

Aetna modified CPB 0781 covering interstitial laser therapy, effective September 26, 2025. Here's what billing teams need to do.

Aetna, a CVS Health company, updated its interstitial laser therapy coverage policy under CPB 0781 to define two specific medically necessary indications — refractory epilepsy and select brain tumor/radiation necrosis cases. The primary CPT codes affected are 61736 and 61737 (laser interstitial thermal therapy, intracranial). Three additional codes — 0673T, 0970T, and 0971T — remain explicitly non-covered under this policy. If your facility performs LITT procedures or treats neuro-oncology patients with Aetna coverage, this policy update changes how you document and code for reimbursement.

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Quick-Reference Table

Field	Detail Copy
Payer	Aetna, a CVS Health company
Policy	Interstitial Laser Therapy — CPB 0781
Policy Code	CPB 0781
Change Type	Modified
Effective Date	September 26, 2025
Impact Level	High
Specialties Affected	Neurosurgery, Neuro-oncology, Epilepsy Surgery, Radiation Oncology, Neurology
Key Action	Audit all pending LITT claims for CPT 61736 and 61737 against the updated medical necessity criteria before submitting on or after September 26, 2025

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Aetna Interstitial Laser Therapy Coverage Criteria and Medical Necessity Requirements 2025

The Aetna interstitial laser therapy coverage policy under CPB 0781 covers two indications. Know them cold before you submit a single claim.

Indication 1: Refractory Epilepsy

Aetna covers interstitial laser therapy for refractory epilepsy — but only when the patient meets the criteria defined in CPB 0394 (Epilepsy Surgery). This is a cross-reference requirement. You must satisfy both policies, not just CPB 0781. If your documentation doesn't show the patient meets CPB 0394 criteria, Aetna will deny the claim. Pull CPB 0394 now and confirm your clinical documentation covers both sets of requirements before the effective date of September 26, 2025.

Indication 2: Brain Metastases, Recurrent Glioblastoma, and Radiation Necrosis

Aetna covers interstitial laser therapy for patients with recurrent brain metastases, recurrent glioblastoma, or radiation necrosis — under two specific conditions. The patient must be a poor surgical candidate for craniotomy and resection. Open surgery must present either prohibitive surgical risk or the tumor must be at a surgically inaccessible site.

Both conditions must be documented. "Poor surgical candidate" alone doesn't get you there. Your attending physician's notes need to explicitly address why open surgery presents prohibitive risk, or why the tumor location makes craniotomy impossible. Vague language like "patient not ideal for open surgery" will not hold up in a prior authorization review or an appeal.

Prior Authorization

Aetna's CPB 0781 does not spell out prior authorization requirements in the summary language — but given the complexity and cost of LITT procedures, prior auth is almost certainly required. Confirm prior authorization requirements for CPT 61736 and 61737 directly with Aetna before scheduling. Don't assume the absence of explicit language means prior auth isn't needed.

Reimbursement Context

LITT procedures carry significant reimbursement value. CPT 61736 covers a single trajectory intracranial LITT with MRI guidance. CPT 61737 covers multiple trajectories for complex or multiple lesions — typically a higher reimbursement level. Getting the medical necessity documentation right the first time is the difference between clean claims and a denial-and-appeal cycle that delays payment by months.

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Aetna Interstitial Laser Therapy Exclusions and Non-Covered Indications

Three CPT codes are explicitly not covered under this policy. Aetna does not cover interstitial laser therapy for the indications associated with these codes.

CPT 0673T — Percutaneous laser ablation of benign thyroid nodules, including imaging guidance. Not covered.

CPT 0970T — Percutaneous laser ablation of benign breast tumors (e.g., fibroadenoma), including imaging guidance. Not covered.

CPT 0971T — Percutaneous laser ablation of malignant breast tumors, including imaging guidance. Not covered.

These are Category III codes, and Aetna's position here is clear. Don't bill 0673T, 0970T, or 0971T expecting coverage under this policy. A claim denial on any of these is not an error — it's the policy working as written. If your practice performs laser ablation for thyroid nodules or breast tumors, you need a separate coverage strategy. These indications are not salvageable under CPB 0781.

The malignant skin lesion destruction codes — 17260 through 17266 — appear in the policy as "other CPT codes related to the CPB." They're listed for reference but are not the primary focus of this policy. Treat them as context, not as a billing pathway under CPB 0781.

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Coverage Indications at a Glance

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Aetna Interstitial Laser Therapy Billing Guidelines and Action Items 2025

Copy Action Items

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CPT, HCPCS, and ICD-10 Codes for Interstitial Laser Therapy Under CPB 0781

Covered CPT Codes (When Medical Necessity Criteria Are Met)

Code	Type	Description Copy
61736	CPT	Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, single trajectory
61737	CPT	Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, multiple trajectories for multiple or complex lesion(s)

Not Covered Under This Policy

Code	Type	Description	Reason Copy
0673T	CPT	Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance	Explicitly not covered for indications listed in CPB 0781
0970T	CPT	Ablation, benign breast tumor (e.g., fibroadenoma), percutaneous, laser, including imaging guidance when performed	Explicitly not covered for indications listed in CPB 0781
0971T	CPT	Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed	Explicitly not covered for indications listed in CPB 0781

Other CPT Codes Referenced in CPB 0781

These codes appear in the policy as related codes. They are not the primary billing pathway under this CPB.

Key ICD-10-CM Diagnosis Codes

The full policy references 457 ICD-10-CM codes. Below are the primary diagnosis code categories most relevant to the covered indications. Confirm the complete code list in CPB 0781 for your full reference.

Malignant Neoplasm of Pancreas (referenced in policy)

Malignant Neoplasm of Bronchus and Lung (referenced in policy)

The complete ICD-10 list in CPB 0781 contains 457 codes spanning multiple organ systems. Review the full list at the Aetna CPB 0781 source policy to confirm all applicable diagnosis codes for your patient population.

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