Hyperhydrosis

Aetna covers surgical treatments for primary focal hyperhidrosis of the axillae, palms, or soles — including sympathectomy procedures (endoscopic/thoracoscopic/open/chemical/clipping/ablation/lumbar/VATS), excision of axillary sweat glands, and axillary liposuction — but does not endorse surgery for secondary hyperhidrosis until the underlying cause is treated. Coverage requires prior failure or intolerance of conservative therapies (oral pharmacotherapy, topical aluminum chloride/extra‑strength antiperspirants, failed iontophoresis or a botulinum toxin trial for axillary disease), documented significant social/professional impairment, and consideration of systemic medications, with ETS/sympathectomy reserved as last‑option treatments due to substantial risks.

"CPT codes covered if selection criteria are met: 32664 Thoracoscopy, surgical; with thoracic sympathectomy"