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 76390? Open Aetna’s official lists and confirm the member’s product there.
9 policies name 76390, those listing the fewest codes first. A policy that names a code may also list it as excluded.
| Policy | Details | Codes | Source |
|---|---|---|---|
| 0202-Magnetic Resonance Spectroscopy (MRS) | 0202 · Commercial | 5 | Original policy ↗ |
| 0236-Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) of the Spine | 0236 · Commercial | 27 | Original policy ↗ |
| 0147-Complex Regional Pain Syndrome (CRPS): Diagnosis | 0147 · Commercial | 32 | Original policy ↗ |
| Huntington's Disease | 0614 · Commercial | 60 | Original policy ↗ |
| Myalgic Encephalomyelitis - Chronic Fatigue Syndrome (ME/CSF) | 0369 · Commercial | 139 | Original policy ↗ |
| Attention Deficit/Hyperactivity Disorder | 0426 · Commercial | 188 | Original policy ↗ |
| 0648-Autism Spectrum Disorders | 0648 · Commercial | 284 | Original policy ↗ |
| Participating provider precertification list for Aetna® | 1013000-01-35 · Effective Nov 1, 2025 · Commercial | 1,389 | Original policy ↗ |
| Participating provider precertification list for Aetna® | Effective Jan 1, 2026 · Commercial | 1,440 | Original policy ↗ |