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 J9263? Open Aetna’s official lists and confirm the member’s product there.

30 policies name J9263, those listing the fewest codes first. A policy that names a code may also list it as excluded.

Aetna policies
PolicyDetailsCodesSource
0683-Oxaliplatin0683 · Commercial6Original policy ↗
1071-Zolbetuximab-clzb (Vyloy)1071 · Commercial7Original policy ↗
1034-Epcoritamab-bysp (Epkinly)1034 · Commercial8Original policy ↗
1080-Penpulimab-kcqx1080 · Commercial9Original policy ↗
0916-Avelumab (Bavencio)0916 · Commercial10Original policy ↗
1019-Tremelimumab-actl (Imjudo)1019 · Commercial10Original policy ↗
1021-Mirvetuximab Soravtansine-gynx (Elahere)1021 · Commercial10Original policy ↗
1036-Glofitamab-gxbm (Columvi)1036 · Commercial10Original policy ↗
0815-Ipilimumab (Yervoy)0815 · Commercial14Original policy ↗
0842-Ziv-Aflibercept (Zaltrap)0842 · Commercial15Original policy ↗
0995-Amivantamab-vmjw (Rybrevant) and Amivantamab and Hyaluronidase-lpuj (Rybrevant Faspro)0995 · Commercial15Original policy ↗
0684-Cetuximab (Erbitux)0684 · Commercial18Original policy ↗
0748-Panitumumab (Vectibix)0748 · Commercial18Original policy ↗
0902-Irinotecan Liposome Injection (Onivyde)0902 · Commercial21Original policy ↗
Enfortumab Vedotin-ejfv (Padcev)0967 · Commercial21Original policy ↗
Retifanlimab-dlwr (Zynyz)1030 · Commercial23Original policy ↗
0883-Ramucirumab (Cyramza)0883 · Commercial24Original policy ↗
0993-Dostarlimab-gxly (Jemperli)0993 · Commercial31Original policy ↗
0955-Polatuzumab vedotin-piiq (Polivy)0955 · Commercial34Original policy ↗
Pemetrexed Products0687 · Commercial35Original policy ↗
0917-Durvalumab (Imfinzi)0917 · Commercial41Original policy ↗
Atezolizumab (Tecentriq) and Atezolizumab and Hyaluronidase-tqjs (Tecentriq Hybreza)0909 · Commercial46Original policy ↗
0978-Lurbinectedin (Zepzelca)0978 · Commercial53Original policy ↗
0892-Nivolumab Products (Opdivo, Opdivo Qvantig, and Opdualag)0892 · Commercial58Original policy ↗
0890-Pembrolizumab Products (Keytruda and Keytruda Qlex)0890 · Commercial82Original policy ↗
Tinnitus Treatments0406 · Commercial87Original policy ↗
Hematopoietic Colony-Stimulating Factors (CSFs)0055 · Commercial91Original policy ↗
0227-Breast and Ovarian Cancer Susceptibility Gene Testing, Prophylactic Mastectomy, and Prophylactic Oophorectomy0227 · Commercial103Original policy ↗
Antiemetic Therapy0724 · Commercial152Original policy ↗
0715-Pharmacogenetic Testing0715 · Commercial231Original 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.