Payer PolicyActive
Macular/Foveal Translocation
AETNA-CPB-0409
Aetna
Effective: June 7, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Macular/foveal translocation is considered experimental/investigational and therefore not covered for age‑related macular degeneration (including subfoveal CNV) or any other indication due to insufficient evidence of safety and effectiveness. The policy imposes no coverage exceptions, cites substantial surgical risks (retinal detachment, PVR, cataract, diplopia, metamorphopsia, etc.), and lists noncovered ICD‑10 codes including H35.051–H35.059 and H35.30–H35.3293.
Coverage Criteria Preview
Key requirements from the full policy
"ICD-10 codes explicitly noted as not covered for indications listed in the CPB (not all inclusive): H35."
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