Aetna · PayerPolicy · AETNA-CPB-0561
Summary of the payer’s published policy. Not a coverage determination — confirm with Aetna before submitting.
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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 |
|---|---|---|
| 81376 | CPT | Covered |
| 82705 | CPT | Covered |
| 82710 | CPT | Covered |
| 84378 | CPT | Covered |
| 84379 | CPT | Covered |
| 84620 | CPT | Covered |
| 86015 | CPT | Covered |
| 86036 | CPT | Covered |
| 86037 | CPT | Covered |
| 86146 | CPT | Covered |
| 86148 | CPT | Covered |
| 86258 | CPT | Covered |
| 86364 | CPT | Covered |
| E10.10 | ICD10CM | Covered |
| E10.9 | ICD10CM | Covered |
| K59.00 | ICD10CM | Covered |
| K59.09 | ICD10CM | Covered |
| K90.0 | ICD10CM | Covered |
| Q90.0 | ICD10CM | Covered |
| Q90.9 | ICD10CM | Covered |
| R10.0 | ICD10CM | Covered |
| R10.9 | ICD10CM | Covered |
| R14.0 | ICD10CM | Covered |
| R19.7 | ICD10CM | Covered |
| R63.4 | ICD10CM | Covered |
| R63.8 | ICD10CM | Covered |
| Z83.79 | ICD10CM | Covered |