Cpt code aetna

CPT Codes / HCPCS Codes / ICD-10 Codes; Code Cod

Policy Scope of Policy. This Clinical Policy Bulletin addresses vagus nerve stimulation. Medical Necessity. Aetna considers vagus nerve electrical stimulators medically necessary durable medical equipment (DME) for shortening the duration or reducing the severity of seizures in members with focal seizures (formerly known as partial onset seizures) who remain refractory to optimal anti ...If you live for 1s and 0s, here are the best ways you can get paid to code. Most programmers make six-digit salaries, check out these jobs! Learn more about how you can start makin...

Did you know?

Aetna considers transcranial magnetic stimulation (TMS) in a healthcare provider’s office medically necessary when the following criteria are met: Administered by an FDA cleared device and utilized in accordance with the Food and Drug Administration (FDA) labeled indications; and; The member is age 18 years or older; andCPT codes covered for indications listed in the CPB: Pathogenic variant in ALPL - no specific code: ICD-10 codes covered if selection criteria are met: E83.30 - E83.39: Disorders of phosphorus metabolism and phosphatases [hypophosphatasia] Androgen receptor (AR) mutation: CPT codes covered for indications listed in the CPB: 0230UCPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 28291: ... Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. ...CPT codes covered if selection criteria are met: 76826: Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study ... Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or ...CPT codes not covered for indications listed in the CPB (not covered when performed using power morcellation): 58140 - 58146: Myomectomy: 58150 - 58294: Hysterectomy: 58541 - 58544: ... Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or ...Patients were clinically (IKS score) and radiographically evaluated during a mean follow-up period of 40 months. A total of 9 patients (10 implants) had a IKS score greater than 160. The mean overall knee score at re-assessment, including failures, increased from 51 points pre-operatively to 78 points post-operatively.Guidelines. We've chosen certain clinical guidelines to help our providers get members high-quality, consistent care that uses services and resources effectively. These include treatment protocols for specific conditions, as well as preventive health measures. These guidelines are intended to clarify standards and expectations.Scope of Policy. This Clinical Policy Bulletin addresses vasectomy procedures. Aetna considers vasectomy reversal medically necessary for the treatment of post-vasectomy pain syndrome if member has failed non-steroidal anti-inflammatory medications and local nerve blocks/steroid injections. Micro-denervation of the spermatic cord.Dosage and Administration. Depo-Testosterone injection is available in two strengths, 100 mg/mL and 200 mg/mL testosterone cypionate, for deep gluteal intramuscular (IM) injection only. Testosterone cypionate is also available in generic formulation in 200 mg/mL in a single-dose vial, which is administered by a healthcare provider.Holter records of 1,319 pediatric patients (54.1 % males and 45.9 % females) were reviewed. Their average age was 6.7 +/- 4.1 years (5 days to 16 years). Indications for which Holter monitoring was done were analyzed as well as all the abnormalities diagnosed and factors that may increase Holter yield.Aetna considers implantable estradiol pellets experimental and investigational because they have been shown to produce unpredictable and fluctuating serum concentrations of estrogen. ... CPT codes not covered if selection criteria are met: 11981: Insertion, non-biodegradable drug delivery implant [not covered when used to implant …Aetna considers one-time testing without prior ascertainment of HCV risk medically necessary for adults aged 18 years and older. ... CPT codes not covered for indications listed in the CPB: Hepatitis E screening - no specific code: ICD-10 codes not covered if indications listed in the CPB: Z94.0 - Z94.9:Table: Applicable CPT / HCPCS / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met:: Single anastomosis duodenal-ileal switch (SADI-S) - no specific codeCPT codes not covered for indications listed in the CPB: The Quell device - no specific code: ICD-10 codes not covered for indications listed in the CPB (not all inclusive): M54.2: Cervicalgia: Combination electrochemical therapy/treatment (CET): CPT codes not covered for indications listed in the CPB:For precertification of immune globulin human intramuscular injection (IGIM) (GamaSTAN), call (866) 752-7021 (Commercial), or fax (888) 267-3277. For Statement of Medical Necessity (SMN) precertification forms, see Specialty Pharmacy Precertification. For Medicare Part B plans, call (866) 503-0857, or fax (844) 268-7263.Aetna considers the following interventions medically necessary: Magnetic resonance imaging (MRI) studies of the knee when any of the following criteria is met: Detection, staging, and post-treatment evaluation of tumor of the knee; or. Persistent knee pain/swelling and/or instability (giving way) when: Not associated with an injury and not ...Table: CPT Codes / HCPCS / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met:: 0421T: Transurethral waterjet ablation of prostate, including control of post-operative bleeding, including ultrasound guidance, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included when performed)Aetna considers correction of surgically induced astigmatism with a corneal relaxing incision ... For screening of genetic variations, all exons from the entire coding regions of the ALDH3A1, LOX, and SPARC genes were directly sequenced to determine the presence of mutations. Control individuals were selected from the general population without ...4 doses administered before school entry, at 2, 4 and 6 to 18 months and 4 to 6 years. Adult primary dose: 2 doses (0.5 ml) subcutaneously, 4 to 8 weeks apart; third dose 6 to 12. Preferred for primary immunization; one-time booster dose for travelers.Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Other CPT codes related to the CPB:: 96401 - 96450: Chemotherapy administration: 96446CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; Bone and Tendon Graft Substitutes and Adjuncts: CPT codes not covered for indications listed in the CPB: 0565T: Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation: 0566TPrecertification of omalizumab (Xolair) is required of all Aetna participating providers and members in applicable plan designs. For precertification of omalizumab call (866) 752-7021 or fax (888) 267-3277. ... CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes not covered for indications listed in the CPB: 95012:As defined in Aetna commercial policies, health care services are not medically necessary when they are more costly than alternative services that are at least as likely to produce equivalent therapeutic or diagnostic results. ... CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Other CPT codes related to the CPB: 83890 - 83914 ...CPT codes not covered for indications listed in the CPB: Dual-energy CT for the evaluation of bone marrow edema and fracture lines in acute vertebral fractures – no specific code : ICD-10 codes not covered for indications listed in the CPB: R60.0: Localized edema: S12.000A - S12.9XXS: Fracture of cervical vertebra and other parts of the neck

Find your plan information. You can find your Evidence of Coverage (EOC), Summary of Benefits, Star Ratings, Formulary — Prescription Drug Coverage, Over-the-counter (OTC) benefit catalog, and more. If you're in a Medicare Advantage plan, your plan name is listed on your member ID card.Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. Visit the secure website, available through www.aetna.com, for more information. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search."Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. Visit the secure website, available through www.aetna.com, for more information. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search."Aetna considers the measurement of procalcitonin (PCT) experimental and investigational for the following indications because of insufficient evidence of its effectiveness (not an all-inclusive list): ... CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 84145: Procalcitonin (PCT ...CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 67036: Vitrectomy, mechanical, pars plana approach: 67039: with focal endolaser photocoagulation: 67040: with endolaser panretinal photocoagulation: 67041: with removal of preretinal cellular membrane (e.g., macular …

Aetna considers cardiopulmonary exercise testing (CPET) medically in any of the following conditions, after performance of standard testing, including echocardiography, and pulmonary function testing with measurement of diffusion capacity and measurement of oxygen desaturation (6-minute walk test): Development of exercise prescription to ...Medical Necessity. Aetna considers voice therapy medically necessary to restore the ability of the member to produce speech sounds from the larynx for any of the following indications: Essential voice tremor; or. Following surgery or traumatic injury to the vocal cords; or. Following treatment for laryngeal (glottic) carcinoma; or.Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met:: 90951: End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of ……

Reader Q&A - also see RECOMMENDED ARTICLES & FAQs. Pharmacy Prior Authorization phone number at. Possible cause: We will define the documentation components necessary to code preventive visi.

Oral medications and injections. Contact Aetna® Pharmacy Management for precertification of oral medications not on this list. Their number is 1-800-414-2386 (TTY: 711) Call 1-866-782-2779 (TTY: 711) for information on injectable medications not listed. For drugs administered orally, by injection or infusion:Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met:: 17110: Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions [covered for keloid scar documented to be painful, ulcerated ...Aetna also no longer covers CPT code 97535 as an audio-only code. The changes to employer-based plans took effect on Dec. 1, 2023. Employer-based plans continue to include payment to PTs for some services when delivered via telehealth and submitted with the appropriate modifier (GT or 95). This continuation applies to codes 97750, 97110, 97112 ...

Medical Necessity. Aetna considers hepatitis B (HepB) vaccine a medically necessary preventive service according to the recommendations of the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP). Transplant candidates of any age. Infants born to HBsAg-positive mothers.76816, 76817 Ultrasound Pregnant Uterus, Real Time With Image Documentation, Follow-U (codes can be used interchangeable but not to exceed 2) 2 76830, 76856,76857 Ultrasound, Transvaginal (codes can be used interchangeableTable: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes not covered for indications listed in the CPB:: MoveR training - no specific code 90867

Policy Scope of Policy. This Clinical Policy Bulletin addres 97124. Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion) HCPCS codes covered if selection criteria are met: G0237. Therapeutic procedures to increase strength or endurance of respiratory muscles, face-. hyphen.The mean age was 45.09 ± 12 years in the VVSS group and 47.08 ± 11 years in the EVLA group (p = 0.113). The average ablated vein length was 31.97 ± 6.83 cm in the VVSS group and 31.65 ± 6.25 cm in the EVLA group (p = 0.97). The average tumescent anesthesia use was 300 ml (range of 60 to 600 ml) in the EVLA group. When you undergo a medical procedure, thereTable: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Des In the world of medical billing and coding, CPT codes play a crucial role. These codes, also known as Current Procedural Terminology codes, are used to identify and document medica... The Availity portal makes it easier to support the day-to CPT codes covered if selection criteria are met: 76512: B-scan (with or without superimposed non-quantitative A-scan) ICD-10 codes covered if selection criteria are met: B94.0: Sequelae of trachoma : E50.6: Vitamin A deficiency with xerophthalmic scars of cornea : H02.841 - H02849: Edema of eyelid: H16.031 - H16.039: Corneal ulcer with …Policy Scope of Policy. This Clinical Policy Bulletin addresses autism spectrum disorders. Medical Necessity. Aetna considers autism spectrum disorder (ASD) evaluation and diagnosis medically necessary when developmental delays or persistent deficits in social communication and social interaction across multiple contexts have been identified and when the evaluation is performed by the ... CPT: Get the latest Camden Property Trust stock price and detTable: CPT Codes / HCPCS Codes / ICD-10 CodMedical Necessity. Aetna considers transrectal ultra In the world of medical billing and coding, CPT codes play a crucial role. These codes, also known as Current Procedural Terminology codes, are used to identify and document medica... Table: CPT Codes / HCPCS Codes / ICD-10 Co Medical Necessity. Aetna considers medical treatment of rosacea medically necessary. However, surgical treatment of disfigurement from rosacea (e.g., scarring and telangiectasias) is considered cosmetic. Aetna considers excision or shaving of rhinophyma medically necessary for the treatment of bleeding or infection refractory to medical therapy ...If you have any questions about authorization requirements or need help with the search tool, contact Aetna Better Health of Kentucky Provider Relations at 1-855-454-0061. For presumptive-80305, 80306 and 80307 are allowed 35 units per calendar year w/o prior authorization. After 35 prior auth is required. Scope of Policy. This Clinical Policy Bulletin address[Laser neurolysis is the non-invasive applicatPrecertification of inclisiran (Leqvio) is required CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+": CPT code not covered for indications listed in the CPB: 92521: Evaluation of speech fluency (eg, stuttering, cluttering) 92522Policy Limitations and Exclusions. Typically, in Aetna HMO plans, the physical therapy benefit is limited to a 60-day treatment period. When this is the case, the treatment period of 60 days applies to a specific condition. In some plan designs this limitation is applied on a calendar year or on a contract-year basis.