Aetna · PayerPolicy · AETNA-CPB-0749
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 |
|---|---|---|
| 92132 | CPT | Covered |
| B48.8 | ICD10CM | Covered |
| B49 | ICD10CM | Covered |
| C69.00 | ICD10CM | Covered |
| C69.02 | ICD10CM | Covered |
| C69.10 | ICD10CM | Covered |
| C69.12 | ICD10CM | Covered |
| D31.10 | ICD10CM | Covered |
| D31.12 | ICD10CM | Covered |
| D36.0 | ICD10CM | Covered |
| D89.810 | ICD10CM | Covered |
| D89.813 | ICD10CM | Covered |
| E83.01 | ICD10CM | Covered |
| E85.9 | ICD10CM | Covered |
| H11.431 | ICD10CM | Covered |
| H11.439 | ICD10CM | Covered |
| H16.101 | ICD10CM | Covered |
| H16.109 | ICD10CM | Covered |
| H17.10 | ICD10CM | Covered |
| H17.13 | ICD10CM | Covered |
| H17.811 | ICD10CM | Covered |
| H17.9 | ICD10CM | Covered |
| H18.331 | ICD10CM | Covered |
| H18.339 | ICD10CM | Covered |
| H21.231 | ICD10CM | Covered |
| H21.239 | ICD10CM | Covered |
| H40 | ICD10CM | Covered |
| H42 | ICD10CM | Covered |
| H44.001 | ICD10CM | Covered |
| H44.009 | ICD10CM | Covered |
| H49.00 | ICD10CM | Covered |
| H50.9 | ICD10CM | Covered |
| H52.00 | ICD10CM | Covered |
| H52.03 | ICD10CM | Covered |
| Q15.0 | ICD10CM | Covered |
| Z01.81 | ICD10CM | Covered |
| Z98.83 | ICD10CM | Covered |