Extracorporeal Shock-Wave Therapy for Musculoskeletal Indications and Soft Tissue Injuries

Aetna covers extracorporeal shock‑wave therapy (CPT 0101T) only for calcific tendinopathy of the shoulder of ≥6 months’ duration with a calcium deposit ≥1 cm and failure of appropriate conservative therapy (rotator cuff codes are covered only if they explicitly map to this calcific tendinopathy). ESWT/EPAT is considered experimental/investigational and not covered for a long list of other indications (e.g., non‑calcific rotator cuff tendonitis, lateral epicondylitis, Achilles and other lower‑limb tendinopathies, osteochondral lesions of the talus, wound healing, etc.) and certain CPTs (0102T; 0512T–0513T; 28890) and many ICD‑10 codes are specifically listed as not covered.

"Tendon injuries and general tendinopathies"

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