Aetna · PayerPolicy · AETNA-CPB-0566
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 |
|---|---|---|
| 65778 | CPT | Covered |
| 65779 | CPT | Covered |
| 65780 | CPT | Covered |
| 67311 | CPT | Covered |
| 67312 | CPT | Covered |
| 67314 | CPT | Covered |
| 67316 | CPT | Covered |
| 67318 | CPT | Covered |
| 67320 | CPT | Covered |
| 67331 | CPT | Covered |
| 67332 | CPT | Covered |
| 67334 | CPT | Covered |
| 67335 | CPT | Covered |
| 67340 | CPT | Covered |
| 67343 | CPT | Covered |
| 67345 | CPT | Covered |
| H49.00 | ICD10CM | Covered |
| H49.9 | ICD10CM | Covered |
| H50.00 | ICD10CM | Covered |
| H50.9 | ICD10CM | Covered |
| H53.10 | ICD10CM | Covered |
| H53.2 | ICD10CM | Covered |
| H53.30 | ICD10CM | Covered |
| H53.34 | ICD10CM | Covered |
| H53.8 | ICD10CM | Covered |
| Z41.1 | ICD10CM | Covered |