Aetna · PayerPolicy · AETNA-CPB-0383
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 |
|---|---|---|
| 17311 | CPT | Covered |
| 17312 | CPT | Covered |
| 17313 | CPT | Covered |
| 17314 | CPT | Covered |
| 17315 | CPT | Covered |
| 88331 | CPT | Covered |
| 88332 | CPT | Covered |
| B35.0 | ICD10CM | Covered |
| B35.9 | ICD10CM | Covered |
| B36.0 | ICD10CM | Covered |
| B36.9 | ICD10CM | Covered |
| B37.2 | ICD10CM | Covered |
| B37.31 | ICD10CM | Covered |
| B37.32 | ICD10CM | Covered |
| B37.84 | ICD10CM | Covered |
| B40.3 | ICD10CM | Covered |
| B43.0 | ICD10CM | Covered |
| B43.2 | ICD10CM | Covered |
| B45.2 | ICD10CM | Covered |
| B46.3 | ICD10CM | Covered |
| B47.0 | ICD10CM | Covered |
| B47.9 | ICD10CM | Covered |
| B48.0 | ICD10CM | Covered |
| B48.8 | ICD10CM | Covered |
| C00.0 | ICD10CM | Covered |
| C00.9 | ICD10CM | Covered |
| C01 | ICD10CM | Covered |
| C02.9 | ICD10CM | Covered |
| C03.0 | ICD10CM | Covered |
| C03.9 | ICD10CM | Covered |
| C04.0 | ICD10CM | Covered |
| C04.9 | ICD10CM | Covered |
| C05.0 | ICD10CM | Covered |
| C06.9 | ICD10CM | Covered |
| C30.0 | ICD10CM | Covered |
| C43.0 | ICD10CM | Covered |
| C43.9 | ICD10CM | Covered |
| C44.01 | ICD10CM | Covered |
| C44.02 | ICD10CM | Covered |
| C44.09 | ICD10CM | Covered |
| C44.111 | ICD10CM | Covered |
| C44.119 | ICD10CM | Covered |
| C44.121 | ICD10CM | Covered |
| C44.129 | ICD10CM | Covered |
| C44.131 | ICD10CM | Covered |
| C44.1392 | ICD10CM | Covered |
| C44.211 | ICD10CM | Covered |
| C44.219 | ICD10CM | Covered |
| C44.221 | ICD10CM | Covered |
| C44.229 | ICD10CM | Covered |
| C44.291 | ICD10CM | Covered |
| C44.299 | ICD10CM | Covered |
| C44.310 | ICD10CM | Covered |
| C44.319 | ICD10CM | Covered |
| C44.320 | ICD10CM | Covered |
| C44.329 | ICD10CM | Covered |
| C44.390 | ICD10CM | Covered |
| C44.399 | ICD10CM | Covered |
| C44.41 | ICD10CM | Covered |
| C44.42 | ICD10CM | Covered |
| C44.49 | ICD10CM | Covered |
| C44.510 | ICD10CM | Covered |
| C44.519 | ICD10CM | Covered |
| C44.520 | ICD10CM | Covered |
| C44.529 | ICD10CM | Covered |
| C44.590 | ICD10CM | Covered |
| C44.599 | ICD10CM | Covered |
| C44.611 | ICD10CM | Covered |
| C44.619 | ICD10CM | Covered |
| C44.621 | ICD10CM | Covered |
| C44.629 | ICD10CM | Covered |
| C44.691 | ICD10CM | Covered |
| C44.699 | ICD10CM | Covered |
| C44.711 | ICD10CM | Covered |
| C44.719 | ICD10CM | Covered |
| C44.721 | ICD10CM | Covered |
| C44.729 | ICD10CM | Covered |
| C44.791 | ICD10CM | Covered |
| C44.799 | ICD10CM | Covered |
| C44.81 | ICD10CM | Covered |
| C44.82 | ICD10CM | Covered |
| C44.89 | ICD10CM | Covered |
| C44.90 | ICD10CM | Covered |
| C44.91 | ICD10CM | Covered |
| C44.92 | ICD10CM | Covered |
| C44.99 | ICD10CM | Covered |
| C51.0 | ICD10CM | Covered |
| C51.9 | ICD10CM | Covered |
| C57.7 | ICD10CM | Covered |
| C57.9 | ICD10CM | Covered |
| C60.0 | ICD10CM | Covered |
| C60.9 | ICD10CM | Covered |
| C63.00 | ICD10CM | Covered |
| C63.9 | ICD10CM | Covered |
| D04.0 | ICD10CM | Covered |
| D04.9 | ICD10CM | Covered |
| D07.60 | ICD10CM | Covered |
| D07.69 | ICD10CM | Covered |
| D48.5 | ICD10CM | Covered |