Aetna cpt codes 2019. 03 : Cervical disc disorder with myelopathy : M50.
Codes requiring a 7th character are represented by "+": Other CPT codes related to the CPB: 96365 - 96368: Intravenous infusion administration: 96372 CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Other CPT codes related to the CPB: 96401 - 96450: Chemotherapy administration : HCPCS codes covered if selection criteria are met: Bevacizumab-tnjn (Avzivi) –no specific code: J9035 : Injection, bevacizumab, 10 mg: Q5107: Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg: Q5118 LMWM-based nanoparticles - no specific code: ICD-10 codes not covered for indications listed in CPB: C50. CPT codes covered if selection criteria are met: 96116 Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities), per hour of the psychologist's or physician's time, both face-to-face time with the patient CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Other CPT codes related to the CPB: 27590 - 27596: Amputation, thigh, through femur: HCPCS codes covered if selection criteria are met: L5000 - L5782, L5785 - L5972, L5974 -L5988, L5999 : Lower limb prostheses : L5930 Aetna considers inhaled nitric oxide CPT Codes / HCPCS Codes / ICD-10 Codes ; Pneumonia due to coronavirus disease 2019: J21. Codes requiring a 7th character are represented by "+": CPT codes covered if selection criteria are met: 94726: Plethysmography for determination of lung volumes and, when performed, airway resistance : Other CPT codes related to the CPB: 94010 CPT Codes / HCPCS Codes / ICD-10 Codes; Code (July 2016 to March 2019) for AAA in the Female Aneurysm screening STudy (FAST). Discover the Aetna difference. Codes requiring a 7th character are represented by "+": Other CPT codes related to the CPB: 36514: Therapeutic apheresis; for plasma pheresis: 96365 – 96368: Intravenous infusion administration: 96372 Codes requiring a 7th character are represented by "+": CPT codes covered for indications listed in the CPB: 55874 : Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed [SpaceOAR, Barrigel] Other CPT codes related to the CPB: 77401 - 77417 CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; Information in the [brackets] below has been added for clarification purposes. ICD-10 codes not covered for indications listed in the CPB: Z12. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; CPT codes covered if selection criteria are met: 0038U : Vitamin D, 25 hydroxy D2 and D3, by LC-MS/MS, serum microsample, quantitative: 82306: Vitamin D; 25 hydroxy, includes fraction(s), if performed: 82652: Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed: ICD-10 Policy Applicable CPT / HCPCS / ICD-10 Codes Background References. 610: Diabetes mellitus with neurological complications: F45. 0 - J21. 0 – K77: Diseases of liver: Serum marker tests: Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met:: 33267: Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) [not covered for open heart surgery] Applicable CPT / HCPCS / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 19318: Reduction mammaplasty: CPT codes not covered for indications listed in the CPB: Vacuum-assisted breast biopsy system, Combined arthroscopic shaver and liposuction - No specific code: 15877 : Suction assisted lipectomy; trunk : 19300 CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes not covered for indications listed in the CPB: Bee Venom Phonophoresis, Contractubex phonophoresis-no specific code: Other CPT codes related to the CPB: 97035: Application of a modality to one or more areas; ultrasound, each 15 minutes : ICD-10 codes not covered for Visit the secure website, available through www. , sensory, motor, language, or visual cortex localization)(List separately in addition to code for primary procedure) Other CPT codes related to the CPB: 61697: Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation: 61698: vertebrobasilar circulation: 61700 tests are cholesterol (CPT code 82465), triglycerides (CPT code 84478), and HDL cholesterol (CPT code 83718), the service shall be reported as a lipid panel (CPT code 80061) (See Chapter I, Section N (Laboratory Panel). Effective . 49 E11. 2: Congenital entropion CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Information in the [brackets] below has been added for clarification purposes. 0 - G45. 0 – Q90. Coverage for Psychiatric Collaborative Care Management (CoCM) Codes (CPT Codes 99492-99494) The American Psychiatric Association has compiled an interim list of payers who have either indicated they have approved coverage for psychiatric collaborative care management (CoCM) codes (CPT codes 99492-99494) or Aug 1, 2024 · See our precertification lists or utilize our CPT code lookup to see whether a procedure or service requires prior approval. Aetna considers phototherapeutic keratectomy (PTK) CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 92133: Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve: 92134: retina: CPT codes not covered for indications listed in the CPB: 0469T Other CPT codes related to the CPB: 90935 - 90999: Dialysis, hemodialysis, and end-stage renal disease services: HCPCS codes covered if selection criteria are met: S2065: Simultaneous pancreas kidney transplantation: HCPCS codes not covered for indications listed in the CPB: Georges Lopez Institute preservation solution (IGL-1) - no specific code Policy Applicable CPT / HCPCS / ICD-10 Codes Background References. 610 E11. Aetna Inc. com, for more information. 1 G45. Aetna considers the following procedures medically necessary as a diagnostic test prior to AETNA BETTER HEALTH® OF KENTUCKY . effective July 1, 2019. 9 Visit the secure website, available through www. 00 - M50. PROVIDER NEWSFLASH - FEBRUARY 08, 2019 - PAGE 1 OF 11 . Codes requiring a 7th character are represented by "+": Other CPT codes related to the CPB: 96365: Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to Visit the secure website, available through www. ) CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 90651: Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 3 dose schedule, for intramuscular use : CPT codes not covered for indications listed in the CPB: 90649 CPT codes covered if selection criteria are met : 23472: Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder) [not covered for those who have an irreparable rotator cuff tear] CPT codes not covered for indications listed in the CPB: Cage glenoid - no specific code: 0054T CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered for indications listed in the CPB: 64600: Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch : 64620: Destruction by neurolytic agent, intercostal nerve: CPT codes not covered for indications listed in CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; Other CPT codes related to the CPB: 96413 - 96417: Chemotherapy administration, intravenous infusion technique: HCPCS codes covered if selection criteria are met: J9196: Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg: J9198 CPT Codes / HCPCS Codes / ICD-10 Codes ; 2019). 40 - E10. 0 : Rheumatic aortic stenosis: I06. ICD-10 codes not covered for indications listed in the CPB (not all-inclusive): K70. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association At a glance A how-to guide for health care professionals who work with us Aetna. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. This code should be used for initial and follow up assessments. 4: Encounter for screening for malignant neoplasm of cervix: DNA methylation: CPT codes not covered for indications listed in the CPB: DNA Methylation – no specific code: Other CPT codes related to the CPB: 57420: Colposcopy of the entire vagina, with cervix if present: 57421 CPT codes not covered for indications listed in the CPB: Crenobalneotherapy -no specific code: ICD-10 codes not covered for indications listed in the CPB: M17. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association In 2018, the AMA introduced three new CPT codes (99453, 99454 and 99457) to address the limitations of the original code and incentivize the adoption of RPM. 9: Gender identity disorders [to stop residual menstrual bleeding after androgen treatment] N92. CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Information in the [brackets] below has been added for clarification purposes. 2017 •ABA Services Work Group presents Code Change Application to CPT Editorial Panel. Y0001_0001_22192_2021_C. CMS began reimbursing these codes in 2019 when they were added to the Medicare Physician Fee Schedule. CPT codes not covered for indications listed in the CPB: 76981 - 76983: Ultrasound, elastography: Other CPT codes related to the CPB: 0395T: High dose rate electronic brachytherapy, interstitial or intracavitary treatment, per fraction, includes basic dosimetry, when performed: 47533 Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met:: 96904: Whole body integumentary photography, for monitoring of high-risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or family history of melanoma CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: Macimorelin (Macrilen) stimulation test - no specific code: CPT codes not covered for indications listed in the CPB: 38205: Blood-derived hematopoetic progenitor cell harvesting for transplantation, per collection; allogenic: 38206 CPT codes not covered for indications listed in the CPB: 95928: Central motor evoked potential study (transcranial motor stimulation); upper limbs: 95929: lower limbs: 95939: in upper and lower limbs: Surgical procedures where motor evoked potentials are not covered for indications listed in the CPB: CPT codes not covered for indications listed CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Information in the [brackets] below has been added for clarification purposes. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: Drug-coated balloon angioplasty –no specific code: 37220 - 37247: Revascularization, endovascular: CPT codes not covered for indications listed in the CPB: 0234T CPT codes covered if selection criteria are met: 67921: Repair of entropion; suture : 67922: thermocauterization: 67923: excision tarsal wedge : 67924: extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation) ICD-10 codes covered if selection criteria are met:: H02. 9: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 78267: Urea breath test, C-14 (isotopic); acquisition for analysis: 78268: analysis: 83013: Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) 83014: drug administration : 87338 CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; Other CPT codes related to the CPB:: 0537T: Chimeric antigen receptor T- cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells, per day: 0538T Applicable CPT / HCPCS / ICD-10 Codes; Code Code Description; Other CPT codes related to the CPB: 27440: Arthroplasty, knee, tibial plateau: 27441: with debridement and partial synovectomy: 27442: Arthroplasty, femoral condyles or tibial plateau(s), knee: 27443: with debridement and partial synovectomy : 27445: Arthroplasty, knee, hinge CPT codes not covered for indications listed in the CPB: Florida Sleeve valve-sparing procedure - no specific code: HCPCS codes not covered for indications listed in the CPB: Decellularized Matrix P bioprosthesis - no specific code: ICD-10 codes covered if selection criteria are met: I06. Aetna® is partnering with EviCore to provide their members with access to specific procedures for Peripheral Vascular Disease. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Other CPT codes related to the CPB:: 0312U: Autoimmune diseases (eg, systemic lupus erythematosus [SLE]), analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorbent immunoassay (ELISA), flow cytometry and indirect immunofluorescence, serum, or plasma and whole blood Codes requiring a 7th character are represented by "+": CPT codes covered if selection criteria are met: 92584 : Electrocochleography: CPT codes not covered for indications listed in the CPB: Superior semicircular canal dehiscence repair, canal resurfacing - no specific code: Other CPT codes related to the CPB: 69930 Aetna considers the following interventions medically necessary: CPT Codes / HCPCS Codes / ICD-10 Codes; (2019) stated that oral mucositis is a common dose June 2019 v. 0 – M17. Policy Scope of Policy. 9: Osteoarthritis of knee: M54. require prior authorization before the services are rendered. 81 CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: Muldowney Method of Physical Therapy – no specific code: 97010: Application of a modality to 1 or more areas; hot or cold packs: 97012: traction, mechanical: 97014: electrical stimulation (unattended) 97016: vasopneumatic devices CPT codes not covered for indications listed in the CPB: Vestibular stimulation, plasma leptin, measurement of serum trace elements, allopregnanolone antagonist, aromatherapy - no specific code: 58150 - 58210, 58260 - 58294 : Hysterectomy (open) 58353: Endometrial ablation, thermal, without hysteroscopic guidance: 58356 CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; Information in the [brackets] below has been added for clarification purposes. IMPORTANT UPDATE: The following CPT codes have been removed from the Aetna Vascular Intervention program, effective immediately. Aetna considers collagenase clostridium histolyticum CPT Codes / HCPCS Codes / ICD-10 Codes; Code (2019) stated that DC is a fibrotic hand condition in which Visit the secure website, available through www. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: Extracorporeal pulse activation therapy (EPAT) - no specific code: 0101T: Extracorporeal shock wave involving musculoskeletal system, not otherwise specified, high energy: CPT codes not covered for indications listed in the CPB: 0102T Update and Clarification - 2019 ABA CPT Codes . Plan features and availability may vary by service area. 0 - K77: Diseases of liver: Serum ferritin: CPT codes not covered for indications listed in the CPB: 82728: Ferritin: ICD-10 codes not covered for indications listed in the CPB (not all-inclusive): K70. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association HCPCS code covered if selection criteria are met: S8042: Magnetic resonance imaging (MRI), low-field: ICD-10 codes covered if selection criteria are met: Too many to list: ICD-10 codes not covered for indications listed in the CPB : M48. 011 - C50. 9: Low back pain: Marine therapy: CPT codes not covered for indications listed in the CPB: Marine therapy - no specific code Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met:: 37243: Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction Aetna considers fecal bacteriotherapy, CPT Codes / HCPCS Codes / ICD-10 Codes; Code (2019) noted that Alzheimer's disease (AD) is the most common dementia in CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 20550 : Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar "fascia") 29893: Endoscopic plantar fasciotomy: CPT codes not covered for indications listed in the CPB: Visit the secure website, available through www. 5: Encounter for screening for eye and ear disorders: iStent Trabecular Micro-Bypass Stent System: CPT codes covered if selection criteria are met: 66989 Visit the secure website, available through www. Codes requiring a 7th character are represented by "+": CPT codes covered if selection criteria are met: 97140 Code Code Description; Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+": Other CPT codes related to the CPB: 97012: Application of a modality to one or more areas; traction, mechanical: 97140 for evoked magnetic fields, each additional modality (e. 2017 •CPT Editorial Panel approves 8 modified codes as Category I and 2 modified codes as CPT III. 0 - A41. 49 E10. CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: + 93325: Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography) Other CPT codes related to the CPB [parent codes for 93325]: 33615 CPT codes not covered for indications listed in the CPB: Artificial intelligence –no specific code: ICD-10 codes not covered for indications listed in the CPB: H40. ©2019 Aetna Inc. Aetna Better Health® of WV continues its commitment to correct coding and the implementation of programs that support nationally recognized and accepted coding policies and practices. Codes requiring a 7th character are represented by "+": CPT codes covered if selection criteria are met: 90670: Pneumococcal conjugate vaccine, 13 valent, for intramuscular use: 90671 CPT codes covered for indications listed in the CPB: 96405: Chemotherapy administration' intralesional, up to and including 7 lesions: 96406: intralesional, more than 7 lesions: HCPCS codes covered if selection criteria are met: J9015: Injection, aldesleukin, per single use vial: ICD-10 codes covered if selection criteria are met: C43. 0 - C43. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Information in the [brackets] below has been added for clarification purposes. ©2020 Aetna Inc. 6: Excessive, frequent and irregular menstruation: ICD-10 codes not covered if selection criteria are met: N95. 929: Malignant neoplasm of breast: Other CPT codes related to the CPB: 27130: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft : 27132 Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: +31627: Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (List separately in addition to code for primary procedure[s]) CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 27416: Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s]) [except to repair chondral defects of the patella] [excludes synthetic resorbable polymers] 29866 CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; Other CPT codes related to the CPB: 43233 - 43259: Esophagogastroduodenoscopy: 44360 - 44379: Endoscopy, small intestine: 44380 - 44408: Endoscopy, stomal: 45300 - 45393: Endoscopy [Colon and rectum] 46600 - 46615: Anoscopy: 72195: Magnetic resonance (eg, proton) imaging, pelvis Updates to Evaluation & Management (E&M) Code Billing. The AMA CPT Editorial Panel deleted one PLA code, specifically, 0057U, and established 21 new PLA codes, specifically, CPT codes 0084U through 0104U CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Speech Therapy other than with cochlear implants or hearing aids: CPT codes covered if selection criteria are met: 92507: Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual: 92508: group, two or more individuals : Other CPT codes CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; Other CPT codes related to the CPB: 86052: Aquaporin-4 (neuromyelitis optica [NMO]) antibody; cell-based immunofluorescence assay (CBA), each: HCPCS codes covered if selection criteria are met: J1303: Injection, ravulizumab-cwvz, 10 mg: Other HCPCS codes related to the CPB •Code Change Application submitted to CPT Editorial Panel. Fax: <<location fax>> Announcing: Prior Authorization Changes Effective . 8 - G45. 9: Sepsis CPT codes covered if selection criteria are met: 95907: Nerve conduction studies; 1-2 studies : 95908: 3-4 studies : 95909: 5-6 studies : 95910: 7-8 studies : 95911: 9-10 studies : 95912: 11-12 studies : 95913: 13 or more studies : CPT codes not covered for indications listed in the CPB: 95905 Ye and colleagues (2019) noted that circular RNAs (circRNAs), a class of newly discovered endogenous non-coding RNAs, have shown large capabilities in gene regulation. 0: Postmenopausal bleeding CPT codes covered if selection criteria are met: 82175: Arsenic: 83015: Heavy metal (eg, arsenic, barium, beryllium, bismuth, antimony, mercury); qualitative, any number of analytes: HCPCS codes not covered for indications listed in the CPB: P2031 : Hair analysis (excluding arsenic) ICD-10 codes covered if selection criteria are met: T37. 039 : Entropion of eyelid : Q10. com 1999051-01-02 (12/23) CPT codes covered if selection criteria are met: Sepsis pathogen panel - no specific code: Other CPT codes related to the CPB: 87040: Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) ICD-10 codes covered if selection criteria are met: A40. PCR-based tests have been developed further into multiplex assays which allow for simultaneous detection of ICD-10 codes covered if selection criteria are met: Q90. 0 CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 82731: Fetal fibronectin, cervicovaginal secretions, semi-quantitative [not covered following insertion of a cervical cerclage] CPT codes not covered for indications listed in the CPB: See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations, and conditions of coverage. 25 mL dosage, for intramuscular: 90627: 0. Codes requiring a 7th character are represented by "+": CPT codes covered if selection criteria are met: 40806: Incision of labial frenum (frenotomy) 40819 Other CPT codes related to the CPB: 42200 - 42225: Palatoplasty: 77401 - 77412: Radiation treatment delivery: HCPCS codes covered if selection criteria are met: D4210 - D4261, D4268, D4274: Dental procedures, surgical services (including usual postoperative care) D7210 - D7251 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 "+": Other CPT codes related to the CPB: 84075: Phosphatase, alkaline: 84078: heat stable (total not included) 84080: isoenzymes: 96365 - 96368 CPT Codes/ HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 90589: Chikungunya virus vaccine, live attenuated, for intramuscular use: 90626: Tick-borne encephalitis virus vaccine, inactivated; 0. Aetna considers the following procedures medically necessary for tubal ligation sterilization: CPT Codes / HCPCS Codes / ICD-10 Codes; In 2019, the agency Applicable CPT / HCPCS / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 11200: Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions [not covered for more than 15 lesions and billed with +11201] 11300 - 11313: Shaving of epidermal or dermal lesions: 11400 -11446. With the new codes there is only one (1) assessment code, 97151. aetna. 13 CPT codes covered if selection criteria are met: 62290: Injection procedure for discography, each level; lumbar [not covered for functional anesthetic discography] 72295: Discography, lumbar, radiological supervision and interpretation [not covered for functional anesthetic discography] CPT codes not covered for indications listed in the CPB: 62291 CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 33946: Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; initiation, veno-venous: 33947: initiation, veno-arterial: 33948: daily management, each day, veno-venous: 33949 Aetna considers stereotactic radiosurgery medically necessary in certain circumstances. 9: Malignant neoplasm of other and unspecified major salivary Other CPT codes related to the CPB: 96413 -96417: Chemotherapy administration: Other CPT codes related to the CPB: 88271 - 88275: Molecular cytogenetics : 99601 - 99602: Home infusion/specialty drug administration: 96365 - 96368: Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug) 96372 Other CPT codes related to the CPB: 78580 - 78599: Diagnostic radiology, (eg, particulates) respiratory system: 94010 - 94624, 94627 - 94799: Pulmonary laboratory medicine: HCPCS codes covered if selection criteria are met: G0237 Aetna considers the following indications as medically necessary for the CPT Codes / HCPCS Codes / ICD-10 Codes Eur J Obstet Gynecol Reprod Biol. g. 2019 •New CPT I and modified CPT III codes take effect January 1, 2019. 5 mL dosage, for intramuscular use: 90675: Rabies vaccine Visit the secure website, available through www. Codes requiring a 7th character are represented by "+": CPT codes not covered for indications listed in the CPB: Constraint-induced movement therapy or constraint-induced aphasia, group-based CIMT – no specific code: 92507 CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Back Braces: Other CPT codes related to the CPB: 22548 - 22812: Arthrodesis: 22840 - 22855: Spinal instrumentation: 63001 - 63051, 63170 - 63200, 63250 - 63290: Laminectomy: HCPCS codes covered if selection criteria are met: CPT codes not covered for indications listed in the CPB: 0607T Remote monitoring of an external continuous pulmonary fluid monitoring system, including measurement of radiofrequency-derived pulmonary fluid levels, heart rate, respiration rate, activity, posture, and cardiovascular rhythm (eg, ECG data), transmitted to a remote 24-hour attended CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Somatosensory evoked potentials (SEPs, SSEPs): CPT codes covered if selection criteria are met: 95925: Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs : 95926: in CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; Antepartum fetal surveillance using NST, CST, BPP, or modified BPP: CPT codes covered if selection criteria are met: 59020 : Fetal contraction stress test: 59025 : Fetal non-stress test: 76805 was effective July 1, 2017, was deleted June 30, 2019, and replaced with CPT code 0548T . Codes requiring a 7th character are represented by "+": Varicella (chicken pox) and combination varicella and measles, mumps and rubella vaccine (MMRV): CPT codes covered if selection criteria are met: 90710 CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; CPT codes covered if selection criteria are met: VENTANA PD-L1 (SP263) Assay - no specific code: Other CPT codes related to the CPB: 96413 - 96417 : Chemotherapy administration; intravenous infusion technique : HCPCS codes covered if selection criteria are met: J9173 : Injection with nerve allograft, each additional strand (List separately in addition to code for primary procedure) Other CPT codes related to the CPB: 19120 - 19126: Excision lesion of breast: 19300 - 19307: Mastectomy procedures: 21740 - 21743 : Reconstructive repair of pectus excavatum or carinatum : HCPCS codes covered if selection criteria are met: HCPCS codes not covered for indications listed in the CPB: Empatica E4 wristband - no specific codes: ICD-10 codes covered if selection criteria are met: E10. 02: Spinal stenosis, cervical region: M50. 10 - M50. Aetna Better Health ® of Louisiana 2400 Veterans Memorial Blvd, Suite 200 . com 3302205-01-01 (4/24) Visit the secure website, available through www. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; CPT codes not covered for indications listed in this CPB: Optical Coherence Tomography of larynx, intra-operative wide-field OCT, OCT for diagnoses of oral cancerous lesion -no specific code: 0485T - 0486T : Optical coherence tomography (OCT) of middle ear, with interpretation and CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Information in the [brackets] below has been added for clarification purposes. 001 - H02. 3 . Provider manual Resources, policies and procedures at your fingertips Aetna. CPT Proprietary Laboratory Analyses (PLA) Coding Changes Effective July 1, 2019. CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; CPT codes covered if selection criteria are met: 0007U: Drug test(s), presumptive, with definitive confirmation of positive results, any number of drug classes, urine, includes specimen verification including DNA authentication in comparison to buccal DNA, per date of service: 0011U Other CPT codes related to the CPB: 33615: Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple Fontan procedure: 33617: Repair of complex cardiac anomalies (eg, single ventricle) by modified Fontan procedure: ICD-10 codes covered if Aetna considers ambulatory electroencephalography CPT Codes / HCPCS Codes / ICD-10 Codes Seizure. Codes requiring a 7th character are represented by "+": CPT codes not covered for indications listed in the CPB [considered incidental to chemotherapy and not separately reimbursed]: 0662T ICD-10 codes covered if selection criteria are met: F64. 2019;64:45-49. 50 – M54. 0 - C08. 2019;240:242 Visit the secure website, available through www. 9: Down Syndrome [in adolescents with OSAS] CPAP: CPT codes covered if selection criteria are met: 94660: Continuous positive airway pressure ventilation (CPAP), initiation and management : HCPCS codes covered if selection criteria are met: A7027 2 | ABA Code Crosswalk - Category III to Category I CPT codes: Effective 1/1/2019 Category III Code Category III Description Time Category I Code Category I Code Description Time Beacon Description Who is present 0364T Adaptive behavior treatment by protocol, administered by technician, face-to-face with one patient; first 30 minutes of Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met:: 37241: Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; Other CPT codes related to the CPB: 96365: Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour: HCPCS codes covered if selection criteria are met: J0791: Injection, crizanlizumab-tmca, 5 mg : ICD-10 codes covered if The SMFM (2012) has stated that the following are fetal and maternal anatomical components for the detailed fetal anatomic ultrasound (CPT code 76811). and its subsidiary 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 "+": Diphtheria, tetanus toxoid, and whole-cell or acellular pertussis vaccines (Boostrix, Adacel): CPT codes covered if selection criteria are met: 90471 CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 90630: Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use : 90653: Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use: 90654 CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met: 97802: Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes: 97803: re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes: 97804 CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Depo-Provera (injectable medroxyprogesterone acetate): Other CPT codes related to the CPB: 96372: Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular : HCPCS codes covered if selection criteria are met: J1050 CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; Information in the [brackets] below has been added for clarification purposes. National Collaborating Centre for Primary CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Other CPT codes related to the CPB: 83890 - 83914 : Molecular diagnostics: 88271 - 88275: Molecular cytogenetics: 88341 - 88344: Immunohistochemistry or immunocytochemistry, per specimen: 88360 - 88361 Visit the secure website, available through www. Codes requiring a 7th character are represented by "+": CPT codes not covered for indications listed in the CPB: 97151 - 97158 : Adaptive Behavior Assessments and treatment : Other CPT codes related to Jan 17, 2019 · LDH wants to ensure that the new assessment codes, 97151 and 97152, are being properly treated as they differ from previous assessment codes. 3. 0 - N92. 40 - E11. To: Network Providers . 2019;156(4):885-889 Codes requiring a 7th character are represented by "+": Simple bunionectomy: CPT codes covered if selection criteria are met: CPT codes not covered for indications listed in the CPB (not all-inclusive): Continuous wound infiltration with local anesthetics - no specific code: Other CPT codes related to the CPB: 11055 - 11057 Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met:: 0571T : Insertion or replacement of implantable cardioverter-defibrillator system with substernal electrode(s), including all imaging guidance and electrophysiological evaluation (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes not covered for indications listed in the CPB: 0100T: Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intra-ocular retinal electrode array, with vitrectomy: 0472T Other HCPCS codes related to the CPB: A4481: Tracheostoma filter, any type, any size, each: A4623: Tracheostomy, inner cannula: A4629: Tracheostomy care kit for established tracheostomy: A7047: Oral interface used with respiratory suction pump, each: A7501 - A7527: Tracheostomy supplies: ICD-10 codes covered if selection criteria are met: C03. 1 : Rheumatic aortic Aetna considers heart transplantation medically necessary for any of the following conditions CPT Codes / HCPCS Codes / ICD-10 Codes; Code (2019) stated that Aetna considers the following interventions medically necessary: CPT Codes / HCPCS Codes / ICD-10 Codes; (2019) updated the 2006 USPSTF recommendation on Aetna considers the following interventions medically necessary: CPT codes not covered for indications listed in the CPB Gastroenterology. will . CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; CPT codes covered if selection criteria are met: Stool Xpert MTB/RIF, , urine-based lipoarabinomannan antigen testing (FujiLAM) – no specific code: 86480: Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon: 86481 Apr 21, 2015 · Code Code Description; Information in the [brackets] below has been added for clarification purposes. March 10, 2019, the following CPT/HCPCS codes . 03 : Cervical disc disorder with myelopathy : M50. 8: Other somatoform disorders: G45. 8X1A Codes requiring a 7th character are represented by "+": CPT codes not covered for indications listed in the CPB: Implantable clip:(Vasclip, VMBC, LLC, Roseville, MN), Vessel Sealing Device (LigaSure) - no specific code: Endoscopic vasectomy - no specific code: ICD-10 codes not covered for indications listed in the CPB (not all-inclusive): N50. Components considered integral to the code are marked with an asterisk: Footnote2 *Component considered integral to the CPT code 76811. Not all components will be required. March 10, 2019. LA-2019-0117 . CPT Codes / HCPCS Codes / ICD-10 Codes; Code (2019) stated that Table: CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; CPT codes covered if selection criteria are met:: 19296: Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy CPT Codes / HCPCS Codes / ICD-10 Codes; Code Code Description; Information in the [brackets] below has been added for clarification purposes. 1 - F64. 001 - H42: Glaucoma: Z13. Master CPT CPT Codes / HCPCS Codes / ICD-10 Codes ; Code Code Description; HCPCS codes covered if selection criteria are met: J9358: Injection, fam-trastuzumab deruxtecan-nxki, 1 mg : ICD-10 codes covered if selection criteria are met: C07: Malignant neoplasm of parotid gland: C08. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association Aetna Resources. " The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association CPT codes covered if selection criteria are met: 95961 Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional. Patients with the grade-3 endometrial cancer (EC) have a generally poor prognosis, and the specific role of circRNAs in the grade-3 EC remains unclear. kovhft dtxfs avkwc kdltjd nxwwd mxthmk mrdpnl plpxx tgcef vfsx