Cranial Remodeling

Aetna covers cranial remodeling bands/helmets as medically necessary for moderate-to-severe positional head deformities (e.g., plagiocephaly, brachycephaly, torticollis-related deformity, deformity from restrictive positioning, post‑operative synostotic plagiocephaly, and deformity from long‑term hyperalimentation) when banding is initiated between 3–12 months of age (brachycephaly initiation after 4 months and before 12 months); banding outside these criteria is not covered. Key requirements: a failed 2‑month trial of conservative repositioning (except after surgery for synostotic plagiocephaly) plus documented anthropometric verification showing either >6 mm asymmetry in specified measures or a cephalic index ≥2 SDs from the mean for brachycephaly.

"CPT/HCPCS/ICD-10: coverage is associated with listed CPT/HCPCS codes (e."

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