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 38242? Open Aetna’s official lists and confirm the member’s product there.

21 policies name 38242, those listing the fewest codes first. A policy that names a code may also list it as excluded.

Aetna policies
PolicyDetailsCodesSource
0891-Blinatumomab (Blincyto)0891 · Commercial5Original policy ↗
0851-Palifermin (Kepivance)0851 · Commercial7Original policy ↗
0838-Stem Cell Transplantation for Myelofibrosis0838 · Commercial9Original policy ↗
0674-Hematopoietic Cell Transplantation for Chronic Myelogenous Leukemia0674 · Commercial11Original policy ↗
0871-Hematopoietic Cell Transplantation for Inherited Metabolic Disorders and Genetic Diseases0871 · Commercial13Original policy ↗
0836-Hematopoietic Cell Transplantation for Myelodysplastic Syndrome0836 · Commercial14Original policy ↗
0811-Hematopoietic Cell Transplantation for Solid Tumors in Adults0811 · Commercial15Original policy ↗
Donor Lymphocyte Infusion0638 · Commercial17Original policy ↗
Hematopoietic Cell Transplantation for Selected Leukemias0640 · Commercial17Original policy ↗
Non-myeloablative Hematopoietic Cell Transplantation (Mini-Allograft / Reduced Intensity Conditioning Transplant)0634 · Commercial19Original policy ↗
Hematopoietic Cell Transplantation for Selected Childhood Solid Tumors0496 · Commercial25Original policy ↗
0867-Clofarabine0867 · Commercial32Original policy ↗
0765-Age-related Macular Degeneration0765 · Commercial47Original policy ↗
0812-Hypoxic Ischemic Encephalopathy0812 · Commercial53Original policy ↗
Huntington's Disease0614 · Commercial60Original policy ↗
Epilepsy Surgery0394 · Commercial84Original policy ↗
Hematopoietic Colony-Stimulating Factors (CSFs)0055 · Commercial91Original policy ↗
0788-Alzheimer's Disease: Experimental, Investigational, or Unproven Treatment0788 · Commercial95Original policy ↗
Recurrent Pregnancy Loss0348 · Commercial109Original policy ↗
Erectile Dysfunction and Peyronie's Disease0007 · Commercial111Original policy ↗
Temporomandibular Disorders0028 · Commercial197Original policy ↗

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Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.