Aetna · PayerPolicy · AETNA-CPB-0271
Summary of the payer’s published policy. Not a coverage determination — confirm with Aetna before submitting.
Free account. Policy pages stay open to everyone.
Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.
| Code | Code system | Status in this policy |
|---|---|---|
| E0637 | HCPCS | Covered |
| E0640 | HCPCS | Covered |
| E0950 | HCPCS | Covered |
| E0988 | HCPCS | Covered |
| E1015 | HCPCS | Covered |
| E1016 | HCPCS | Covered |
| E1017 | HCPCS | Covered |
| E1018 | HCPCS | Covered |
| E1037 | HCPCS | Covered |
| E1038 | HCPCS | Covered |
| E1039 | HCPCS | Covered |
| E2201 | HCPCS | Covered |
| E2204 | HCPCS | Covered |
| E2207 | HCPCS | Covered |
| E2213 | HCPCS | Covered |
| E2230 | HCPCS | Covered |
| E2301 | HCPCS | Covered |
| E2310 | HCPCS | Covered |
| E2311 | HCPCS | Covered |
| E2321 | HCPCS | Covered |
| E2367 | HCPCS | Covered |
| E2383 | HCPCS | Covered |
| E2603 | HCPCS | Covered |
| E2604 | HCPCS | Covered |
| E2605 | HCPCS | Covered |
| E2606 | HCPCS | Covered |
| E2607 | HCPCS | Covered |
| E2608 | HCPCS | Covered |
| E2610 | HCPCS | Covered |
| E2613 | HCPCS | Covered |
| E2614 | HCPCS | Covered |
| E2615 | HCPCS | Covered |
| E2616 | HCPCS | Covered |
| E2619 | HCPCS | Covered |
| E2620 | HCPCS | Covered |
| E2621 | HCPCS | Covered |
| E2622 | HCPCS | Covered |
| E2623 | HCPCS | Covered |
| E2624 | HCPCS | Covered |
| E2625 | HCPCS | Covered |
| E2626 | HCPCS | Covered |
| E2627 | HCPCS | Covered |
| E2628 | HCPCS | Covered |
| E2629 | HCPCS | Covered |
| E2630 | HCPCS | Covered |
| E2631 | HCPCS | Covered |
| E2632 | HCPCS | Covered |
| E2633 | HCPCS | Covered |
| K0001 | HCPCS | Covered |
| K0002 | HCPCS | Covered |
| K0003 | HCPCS | Covered |
| K0004 | HCPCS | Covered |
| K0005 | HCPCS | Covered |
| K0006 | HCPCS | Covered |
| K0007 | HCPCS | Covered |
| K0008 | HCPCS | Covered |
| K0009 | HCPCS | Covered |
| K0010 | HCPCS | Covered |
| K0011 | HCPCS | Covered |
| K0012 | HCPCS | Covered |
| K0013 | HCPCS | Covered |
| K0014 | HCPCS | Covered |
| K0015 | HCPCS | Covered |
| K0017 | HCPCS | Covered |
| K0018 | HCPCS | Covered |
| K0020 | HCPCS | Covered |
| K0038 | HCPCS | Covered |
| K0039 | HCPCS | Covered |
| K0046 | HCPCS | Covered |
| K0047 | HCPCS | Covered |
| K0052 | HCPCS | Covered |
| K0053 | HCPCS | Covered |
| K0056 | HCPCS | Covered |
| K0108 | HCPCS | Covered |
| K0195 | HCPCS | Covered |
| K0669 | HCPCS | Covered |
| K0733 | HCPCS | Covered |
| K0739 | HCPCS | Covered |
| K0800 | HCPCS | Covered |
| K0801 | HCPCS | Covered |
| K0802 | HCPCS | Covered |
| K0806 | HCPCS | Covered |
| K0807 | HCPCS | Covered |
| K0808 | HCPCS | Covered |
| K0812 | HCPCS | Covered |
| K0813 | HCPCS | Covered |
| K0814 | HCPCS | Covered |
| K0815 | HCPCS | Covered |
| K0816 | HCPCS | Covered |
| K0820 | HCPCS | Covered |
| K0821 | HCPCS | Covered |
| K0822 | HCPCS | Covered |
| K0823 | HCPCS | Covered |
| K0824 | HCPCS | Covered |
| K0825 | HCPCS | Covered |
| K0826 | HCPCS | Covered |
| K0827 | HCPCS | Covered |
| K0828 | HCPCS | Covered |
| K0829 | HCPCS | Covered |
| K0830 | HCPCS | Covered |
| K0831 | HCPCS | Covered |
| K0835 | HCPCS | Covered |
| K0836 | HCPCS | Covered |
| K0837 | HCPCS | Covered |
| K0838 | HCPCS | Covered |
| K0839 | HCPCS | Covered |
| K0840 | HCPCS | Covered |
| K0841 | HCPCS | Covered |
| K0842 | HCPCS | Covered |
| K0843 | HCPCS | Covered |
| K0848 | HCPCS | Covered |
| K0849 | HCPCS | Covered |
| K0850 | HCPCS | Covered |
| K0851 | HCPCS | Covered |
| K0852 | HCPCS | Covered |
| K0853 | HCPCS | Covered |
| K0854 | HCPCS | Covered |
| K0855 | HCPCS | Covered |
| K0856 | HCPCS | Covered |
| K0857 | HCPCS | Covered |
| K0858 | HCPCS | Covered |
| K0859 | HCPCS | Covered |
| K0860 | HCPCS | Covered |
| K0861 | HCPCS | Covered |
| K0862 | HCPCS | Covered |
| K0863 | HCPCS | Covered |
| K0864 | HCPCS | Covered |
| K0868 | HCPCS | Covered |
| K0869 | HCPCS | Covered |
| K0870 | HCPCS | Covered |
| K0871 | HCPCS | Covered |
| K0877 | HCPCS | Covered |
| K0878 | HCPCS | Covered |
| K0879 | HCPCS | Covered |
| K0880 | HCPCS | Covered |
| K0884 | HCPCS | Covered |
| K0885 | HCPCS | Covered |
| K0886 | HCPCS | Covered |
| K0890 | HCPCS | Covered |
| K0891 | HCPCS | Covered |
| K0898 | HCPCS | Covered |
| K0899 | HCPCS | Covered |
| E1039 | ICD10CM | Covered |
| G10 | ICD10CM | Covered |
| G11.8 | ICD10CM | Covered |
| G11.9 | ICD10CM | Covered |
| G12.0 | ICD10CM | Covered |
| G12.9 | ICD10CM | Covered |
| G14 | ICD10CM | Covered |
| G20 | ICD10CM | Covered |
| G21.9 | ICD10CM | Covered |
| G24.1 | ICD10CM | Covered |
| G30.0 | ICD10CM | Covered |
| G30.9 | ICD10CM | Covered |
| G31.9 | ICD10CM | Covered |
| G35 | ICD10CM | Covered |
| G37.9 | ICD10CM | Covered |
| G71.00 | ICD10CM | Covered |
| G71.09 | ICD10CM | Covered |
| G80.0 | ICD10CM | Covered |
| G80.9 | ICD10CM | Covered |
| G81.00 | ICD10CM | Covered |
| G82.54 | ICD10CM | Covered |
| G95.89 | ICD10CM | Covered |
| G95.9 | ICD10CM | Covered |
| K0820 | ICD10CM | Covered |
| K0821 | ICD10CM | Covered |
| K0822 | ICD10CM | Covered |
| K0823 | ICD10CM | Covered |
| K0824 | ICD10CM | Covered |
| K0825 | ICD10CM | Covered |
| K0826 | ICD10CM | Covered |
| K0850 | ICD10CM | Covered |
| K0851 | ICD10CM | Covered |
| K0852 | ICD10CM | Covered |
| K0854 | ICD10CM | Covered |
| K0855 | ICD10CM | Covered |
| K0856 | ICD10CM | Covered |
| K0859 | ICD10CM | Covered |
| L89.100 | ICD10CM | Covered |
| L89.159 | ICD10CM | Covered |
| L89.300 | ICD10CM | Covered |
| L89.329 | ICD10CM | Covered |
| L89.40 | ICD10CM | Covered |
| L89.45 | ICD10CM | Covered |
| L89.890 | ICD10CM | Covered |
| L89.899 | ICD10CM | Covered |
| Q05.0 | ICD10CM | Covered |
| Q05.9 | ICD10CM | Covered |
| Q06.9 | ICD10CM | Covered |
| Q68.8 | ICD10CM | Covered |
| Q74.3 | ICD10CM | Covered |
| Q76.411 | ICD10CM | Covered |
| Q76.49 | ICD10CM | Covered |
| Q78.0 | ICD10CM | Covered |
| Q79.8 | ICD10CM | Covered |
| Q79.9 | ICD10CM | Covered |
| R29.3 | ICD10CM | Covered |
| S06. | ICD10CM | Covered |