Rosacea

Aetna considers medical treatment of rosacea medically necessary — covering topical oxymetazoline (Rhofade) for persistent facial erythema in adults and excision/shaving of rhinophyma (e.g., CPT 30120; CPT 10040 for acute rosacea) when selection criteria are met, with rhinophyma surgery limited to bleeding or infection refractory to medical therapy (e.g., repeated cautery or frequent antibiotics). Cosmetic procedures to correct disfigurement (scarring/telangiectasias) are excluded, and numerous diagnostics and therapies (e.g., botulinum toxin, photodynamic therapy, topical calcineurin inhibitors, reflectance confocal microscopy, and specified lab tests) are considered experimental/investigational and not covered.

"Aetna considers medical treatment of rosacea medically necessary."

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