Aetna policies
Search Aetna's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.
Checking prior authorization for 21030? Open Aetna’s official lists and confirm the member’s product there.
3 policies name 21030, those listing the fewest codes first. A policy that names a code may also list it as excluded.
| Policy | Details | Codes | Source |
|---|---|---|---|
| Neuralgia Inducing Cavitational Osteonecrosis (NICO) and Ultrasonograph Bone Densitometer to Detect NICO | 0642 · Commercial | 15 | Original policy ↗ |
| 0124-General Anesthesia and Monitored Anesthesia Care for Oral and Maxillofacial Surgery and Dental Services | 0124 · Commercial | 19 | Original policy ↗ |
| 0082-Dental Services and Oral and Maxillofacial Surgery: Coverage Under Medical Plans | 0082 · Commercial | 156 | Original policy ↗ |