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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 84403? Open Aetna’s official lists and confirm the member’s product there.

11 policies name 84403, those listing the fewest codes first. A policy that names a code may also list it as excluded.

Aetna policies
PolicyDetailsCodesSource
1015-Testosterone Enanthate Injection1015 · Commercial6Original policy ↗
1014-Testosterone Cypionate Injections1014 · Commercial7Original policy ↗
Testosterone Undecanoate (Aveed) Injection0528 · Commercial8Original policy ↗
Implantable Hormone Pellets0345 · Commercial9Original policy ↗
Gonadotropin-Releasing Hormone Analogs and Antagonists0501 · Commercial29Original policy ↗
Salivary Tests0608 · Commercial34Original policy ↗
0929-Lutetium Lu Dotatate (Lutathera) and Lutetium Lu 177 Vipivotide Tetraxetan (Pluvicto)0929 · Commercial37Original policy ↗
0812-Hypoxic Ischemic Encephalopathy0812 · Commercial53Original policy ↗
Erectile Dysfunction and Peyronie's Disease0007 · Commercial111Original policy ↗
0499-Nonstandard Laboratory Test Panels0499 · Commercial121Original policy ↗
Infertility0327 · Commercial323Original policy ↗

Back to Aetna · Aetna prior authorization CPT list

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.

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