Radiation Treatment for Selected Nononcologic Indications

Aetna covers low- or high‑dose superficial or interstitial radiation as adjunctive therapy for keloids (when excision is medically necessary and radiation is given within 7 days), radiation to prevent heterotopic ossification in defined high‑risk patients, radiation for Ledderhose disease after failure of conventional treatments, and beta irradiation for pterygium not manageable medically; it considers TRASER for nasal telangiectasias and ablative radiotherapy for cardiac arrhythmia experimental/investigational and does not cover associated CPT/ICD codes for those indications. Key requirements: documented medical necessity or failed conservative therapy/high‑risk criteria, timing ≤7 days post‑keloid excision, and use of covered CPT codes (77401–77417, 77767–77772, 77778) only when selection criteria are met.

"Aetna considers low-dose or high-dose radiation (superficial or interstitial) medically necessary as an adjunctive therapy immediately following excisional surgery (within 7 days) in the treatment ..."