Aetna policy
0874-Radium Ra 223 Dichloride (Xofigo)
0874-Radium Ra 223 Dichloride (Xofigo) is a public Aetna policy (policy 0874). It lists 20 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
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- Payer
- Aetna
- Policy number
- 0874
- Line of business
- Commercial
- Source
- www.aetna.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
| Code | Other Aetna policies |
|---|---|
| 0600T | Policies naming 0600T |
| 0601T | Policies naming 0601T |
| 54520 | Policies naming 54520 |
| 54522 | Policies naming 54522 |
| 54530 | Policies naming 54530 |
| 54535 | Policies naming 54535 |
| 96413 | Policies naming 96413 |
| 96417 | Policies naming 96417 |
| A9606 | Policies naming A9606 |
| J9041 | Policies naming J9041 |
| J9046 | Policies naming J9046 |
| J9048 | Policies naming J9048 |
| J9049 | Policies naming J9049 |
| J9051 | Policies naming J9051 |
| J9155 | Policies naming J9155 |
| J9171 | Policies naming J9171 |
| J9202 | Policies naming J9202 |
| J9217 | Policies naming J9217 |
| J9218 | Policies naming J9218 |
| J9219 | Policies naming J9219 |