Aetnas Medical Criteria

Medical Clinical Policy Bulletins - Aetna

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

Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public …

Physical Therapy - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/300_399/0325.html

Aetna considers physical therapy (PT) medically necessary when this care is prescribed by a chiropractor, DO, MD, nurse practitioner, podiatrist or other health professional …

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 …

Allergy and Hypersensitivity - Medical Clinical Policy …

https://www.aetna.com/cpb/medical/data/1_99/0038.html

Cataract Surgery - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/500_599/0508.html

Aetna considers Optiwave Refractive Analysis (ORA) not medically necessary for cataract surgery. Cataract removal surgery is considered not medically necessary for the following …

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

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

Aetna considers ankle orthoses, ankle-foot orthoses (AFOs), and knee-ankle-foot orthoses (KAFOs) medically necessary durable medical equipment (DME) according to the …

Nutritional Support - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/1_99/0061.html

Aetna considers parenteral nutrition medically necessary for members who meet any of the following criteria: Documentation of a failure of enteral (i.e., oral or tube feeding) …

Botulinum Toxin - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/100_199/0113.html

Criteria for Initial Approval. Aetna considers onabotulinumtoxinA (Botox) medically necessary for any of the following indications: Achalasia. Treatment of achalasia when …

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 …