Hyperhidrosis: Surgical Treatments - (0037)

Cigna covers endoscopic thoracic sympathectomy (ETS) for primary palmar and axillary hyperhidrosis and surgical removal of axillary sweat glands (including curettage and combined liposuction approaches) for primary axillary hyperhidrosis, but excludes liposuction as the sole removal method, sympathectomy for craniofacial or secondary hyperhidrosis, and repeat/reversal ETS. Coverage requires documentation of primary (not secondary) hyperhidrosis, failure of at least two nonsurgical treatments, and either medical complications or a significant impact on activities of daily living, plus appropriate CPT coding and informed consent.

"Endoscopic thoracic sympathectomy (ETS) for the treatment of primary palmar and axillary hyperhidrosis is considered medically necessary when BOTH of the following criteria are met:"

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