Aetna Medical Criteria

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Medical Clinical Policy Bulletins - Aetna

https://www.aetna.com/health-care-professionals/clinical-policy-bulletins/medical-clinical-policy-bulletins.html

The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT®), copyright 2015 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and …

Clinical guidelines and policy bulletins - Aetna

https://www.aetnabetterhealth.com/clinical-guidelines-policy-bulletins.html

Clinical Guidelines & Policy Bulletins for Medicaid Providers | Aetna Medicaid Login Aetna Better Health® Clinical guidelines and policy bulletins Guidelines We’ve chosen certain …

Prior Authorization Process FAQs & Guidelines | Aetna

https://www.aetna.com/individuals-families/prior-authorization-guidelines.html

Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed …

Obstructive Sleep Apnea in Adults - Medical Clinical …

https://www.aetna.com/cpb/medical/data/1_99/0004.html

Aetna considers the following tests medically necessary for diagnosing obstructive sleep apnea (OSA) in adults aged 18 years and older when criteria are met: Attended Full …

Ankle Orthoses, Ankle-Foot Orthoses (AFOs), and Knee …

https://www.aetna.com/cpb/medical/data/500_599/0565.html

Policy Ankle Orthotics Aetna considers ankle orthoses medically necessary DME for members who meet the criteria set forth below. Ankle air-stirrups Ankle air-stirrups (e.g., …

Cosmetic Surgery and Procedures - Medical Clinical …

https://www.aetna.com/cpb/medical/data/1_99/0031.html

Aetna plans exclude coverage of cosmetic surgery and procedures that are not medically necessary, but generally provide coverage when the surgery or procedure is needed to …

Precertification Lists - Aetna

https://qawww.aetna.com/health-care-professionals/precertification/precertification-lists.html

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its …

Infertility - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/300_399/0327.html

Criteria for Initial Approval Aetna considers hCG medically necessary for members undergoing ovulation induction or assisted reproductive technology (ART). Aetna …

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