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 D4341? Open Aetna’s official lists and confirm the member’s product there.
4 policies name D4341, those listing the fewest codes first. A policy that names a code may also list it as excluded.
| Policy | Details | Codes | Source |
|---|---|---|---|
| [Dental] 041 - Scaling and Root Planing | 041 · Commercial | 4 | Original policy ↗ |
| [Dental] 042 - Scaling in Presence of Generalized Moderate or Severe Gingival Inflammation | 042 · Commercial | 4 | Original policy ↗ |
| [Dental] 040 - InitialPeriodontal Therapy Reevaluation | 040 · Commercial | 5 | Original policy ↗ |
| Periodontal pocket reduction surgery (012) | 012 · Effective Mar 13, 2026 · Commercial | 9 | Original policy ↗ |