Thoracoscopic Sympathectomy

Aetna covers thoracoscopic sympathectomy only for causalgia; CPVT that remains symptomatic despite maximal medical therapy; long QT syndrome after failed medical therapy with frequent ICD shocks despite medications; Raynaud disease; and shoulder‑hand syndrome, and considers other uses (e.g., acne, craniofacial or plantar hyperhidrosis), left-sided sympathectomy for cardiac denervation in heart failure, and treatment of facial blushing to be experimental, investigational, or cosmetic and not covered. Coverage is limited to these explicit medically necessary indications (hyperhidrosis requires prior‑treatment criteria) and specific ICD‑10 codes for heart failure, acne, facial/plantar hyperhidrosis, and flushing are listed as not covered.

"Intractable, disabling axillary or palmar primary hyperhidrosis (excessive sweating) when all of the following are met:"

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