Aetna · PayerPolicy · AETNA-CPB-0707
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 |
|---|---|---|
| 14040 | CPT | Covered |
| 14041 | CPT | Covered |
| 14060 | CPT | Covered |
| 14061 | CPT | Covered |
| 15824 | CPT | Covered |
| 15826 | CPT | Covered |
| 37600 | CPT | Covered |
| 37606 | CPT | Covered |
| 37609 | CPT | Covered |
| 43631 | CPT | Covered |
| 43635 | CPT | Covered |
| 43644 | CPT | Covered |
| 43645 | CPT | Covered |
| 43770 | CPT | Covered |
| 43775 | CPT | Covered |
| 43842 | CPT | Covered |
| 43848 | CPT | Covered |
| 43886 | CPT | Covered |
| 43888 | CPT | Covered |
| 61796 | CPT | Covered |
| 61797 | CPT | Covered |
| 61798 | CPT | Covered |
| 61799 | CPT | Covered |
| 61800 | CPT | Covered |
| 61850 | CPT | Covered |
| 61860 | CPT | Covered |
| 61863 | CPT | Covered |
| 61864 | CPT | Covered |
| 61867 | CPT | Covered |
| 61868 | CPT | Covered |
| 61870 | CPT | Covered |
| 61880 | CPT | Covered |
| 61885 | CPT | Covered |
| 61886 | CPT | Covered |
| 61888 | CPT | Covered |
| 62280 | CPT | Covered |
| 62281 | CPT | Covered |
| 63020 | CPT | Covered |
| 63035 | CPT | Covered |
| 63040 | CPT | Covered |
| 63043 | CPT | Covered |
| 63045 | CPT | Covered |
| 63048 | CPT | Covered |
| 63050 | CPT | Covered |
| 63075 | CPT | Covered |
| 63076 | CPT | Covered |
| 63077 | CPT | Covered |
| 63081 | CPT | Covered |
| 63082 | CPT | Covered |
| 63185 | CPT | Covered |
| 63190 | CPT | Covered |
| 63650 | CPT | Covered |
| 63655 | CPT | Covered |
| 63661 | CPT | Covered |
| 63662 | CPT | Covered |
| 63663 | CPT | Covered |
| 63664 | CPT | Covered |
| 63685 | CPT | Covered |
| 63688 | CPT | Covered |
| 64400 | CPT | Covered |
| 64405 | CPT | Covered |
| 64408 | CPT | Covered |
| 64418 | CPT | Covered |
| 64450 | CPT | Covered |
| 64505 | CPT | Covered |
| 64510 | CPT | Covered |
| 64550 | CPT | Covered |
| 64553 | CPT | Covered |
| 64555 | CPT | Covered |
| 64565 | CPT | Covered |
| 64568 | CPT | Covered |
| 64569 | CPT | Covered |
| 64570 | CPT | Covered |
| 64575 | CPT | Covered |
| 64580 | CPT | Covered |
| 64585 | CPT | Covered |
| 64590 | CPT | Covered |
| 64600 | CPT | Covered |
| 64612 | CPT | Covered |
| 64616 | CPT | Covered |
| 64633 | CPT | Covered |
| 64634 | CPT | Covered |
| 64640 | CPT | Covered |
| 64702 | CPT | Covered |
| 64716 | CPT | Covered |
| 64722 | CPT | Covered |
| 64727 | CPT | Covered |
| 64732 | CPT | Covered |
| 64734 | CPT | Covered |
| 64744 | CPT | Covered |
| 64771 | CPT | Covered |
| 64802 | CPT | Covered |
| 64804 | CPT | Covered |
| 67900 | CPT | Covered |
| 77371 | CPT | Covered |
| 77372 | CPT | Covered |
| 77432 | CPT | Covered |
| 93580 | CPT | Covered |
| 95836 | CPT | Covered |
| 95970 | CPT | Covered |
| 95971 | CPT | Covered |
| 95972 | CPT | Covered |
| 95976 | CPT | Covered |
| 95977 | CPT | Covered |
| 95983 | CPT | Covered |
| 95984 | CPT | Covered |
| 97014 | CPT | Covered |
| A4556 | HCPCS | Covered |
| A4557 | HCPCS | Covered |
| A4558 | HCPCS | Covered |
| A4595 | HCPCS | Covered |
| C1767 | HCPCS | Covered |
| C1778 | HCPCS | Covered |
| C1816 | HCPCS | Covered |
| C1883 | HCPCS | Covered |
| C1897 | HCPCS | Covered |
| E0720 | HCPCS | Covered |
| E0730 | HCPCS | Covered |
| E0731 | HCPCS | Covered |
| E0735 | HCPCS | Covered |
| E0745 | HCPCS | Covered |
| G0173 | HCPCS | Covered |
| G0251 | HCPCS | Covered |
| G0339 | HCPCS | Covered |
| G0340 | HCPCS | Covered |
| J0585 | HCPCS | Covered |
| J0587 | HCPCS | Covered |
| J0588 | HCPCS | Covered |
| L8679 | HCPCS | Covered |
| L8680 | HCPCS | Covered |
| L8681 | HCPCS | Covered |
| L8682 | HCPCS | Covered |
| L8683 | HCPCS | Covered |
| L8685 | HCPCS | Covered |
| L8686 | HCPCS | Covered |
| L8687 | HCPCS | Covered |
| L8688 | HCPCS | Covered |
| L8689 | HCPCS | Covered |
| L8695 | HCPCS | Covered |
| G43. | ICD10CM | Covered |
| G43.001 | ICD10CM | Covered |
| G43.919 | ICD10CM | Covered |
| G44.001 | ICD10CM | Covered |
| G44.89 | ICD10CM | Covered |
| M31.6 | ICD10CM | Covered |
| M54.81 | ICD10CM | Covered |
| M79.2 | ICD10CM | Covered |
| R51.0 | ICD10CM | Covered |
| R51.9 | ICD10CM | Covered |