Anecortave Acetate (Retaane) | Aetna | Backwork

Anecortave Acetate (Retaane)

Aetna · PayerPolicy · AETNA-CPB-0706

Status: Active
Effective: September 20, 2023
Last reviewed by Aetna: November 24, 2025
Last checked by Backwork: August 1, 2026

Summary of the payer’s published policy. Not a coverage determination — confirm with Aetna before submitting.

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Codes in this policy

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.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
C69.20	ICD10CM	Covered
C69.22	ICD10CM	Covered
H35.3110	ICD10CM	Covered
H35.3293	ICD10CM	Covered
H40.001	ICD10CM	Covered
H42	ICD10CM	Covered