Endometrial Ablation | Aetna | Backwork

Endometrial Ablation

Aetna · PayerPolicy · AETNA-CPB-0091

Status: Active
Effective: March 21, 2023
Last reviewed by Aetna: March 25, 2026
Last checked by Backwork: August 1, 2026

Summary of the payer’s published policy. Not a coverage determination — confirm with Aetna before submitting.

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Codes in this policy

Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
58353	CPT	Covered
58356	CPT	Covered
58563	CPT	Covered
J7297	HCPCS	Covered
J7298	HCPCS	Covered
F64.1	ICD10CM	Covered
F64.9	ICD10CM	Covered
N92.0	ICD10CM	Covered
N92.6	ICD10CM	Covered
N95.0	ICD10CM	Covered