Endometrial Ablation

Aetna covers endometrial ablation for menorrhagia (including stopping residual bleeding in FTM transgender patients who meet gonadectomy criteria) using established methods (chemical, cryo, electrosurgical, laser, microwave, radiofrequency, thermo/hydrothermal/balloon) and excludes ablation for other indications (e.g., postmenopausal bleeding ICD‑10 N95.0) or uses deemed experimental/investigational. Key requirements: menorrhagia must be unresponsive to or contraindicated for dilation and curettage or hormonal/other pharmacotherapy (or these less invasive options tried within the past year), severity/persistence should make the patient a hysterectomy candidate, endometrial sampling must exclude hyperplasia/cancer, and structural abnormalities (fibroids/polyps) that would contraindicate ablation must be ruled out.

"Endometrial ablation is medically necessary for women with menorrhagia who meet ALL selection criteria (see policy)."