Talk to Us

Aetna prior authorization and CPT code lookup, page 12

CPT code lookup

Each row is one code from the participating-provider precertification list. This is not a coding dictionary, and it is not a coverage decision. The description is the service name on that list.

Participating-provider outpatient list

Inpatient, emergency, and observation settings are outside this outpatient list. This page does not publish a determination for those settings.

Prior authorization codes

Prior authorization codes
CodeDescriptionSource
63082Spinal procedures (continued): Vertebral corpectomyParticipating provider precertification list for Aetna, Pg 14 Original policy
63085Spinal procedures (continued): Vertebral corpectomyParticipating provider precertification list for Aetna, Pg 14 Original policy
63086Spinal procedures (continued): Vertebral corpectomyParticipating provider precertification list for Aetna, Pg 14 Original policy
63090Spinal procedures (continued): Vertebral corpectomyParticipating provider precertification list for Aetna, Pg 14 Original policy
63091Spinal procedures (continued): Vertebral corpectomyParticipating provider precertification list for Aetna, Pg 14 Original policy
22510Spinal procedures (continued): Vertebroplasty/kyphoplastyParticipating provider precertification list for Aetna, Pg 14 Original policy
22511Spinal procedures (continued): Vertebroplasty/kyphoplastyParticipating provider precertification list for Aetna, Pg 14 Original policy
22512Spinal procedures (continued): Vertebroplasty/kyphoplastyParticipating provider precertification list for Aetna, Pg 14 Original policy
22513Spinal procedures (continued): Vertebroplasty/kyphoplastyParticipating provider precertification list for Aetna, Pg 14 Original policy
22514Spinal procedures (continued): Vertebroplasty/kyphoplastyParticipating provider precertification list for Aetna, Pg 14 Original policy
22515Spinal procedures (continued): Vertebroplasty/kyphoplastyParticipating provider precertification list for Aetna, Pg 14 Original policy
E0766Stimulators Electrical stimulation device used for cancer treatmentParticipating provider precertification list for Aetna, Pg 14 Original policy
53445Urology Artificial urinary sphincterParticipating provider precertification list for Aetna, Pg 14 Original policy
42145Uvulopalatopharyngoplasty, including laser-assisted procedures*Participating provider precertification list for Aetna, Pg 14 Original policy
42140Uvulopalatopharyngoplasty, including laser-assisted procedures*Participating provider precertification list for Aetna, Pg 14 Original policy
42299Uvulopalatopharyngoplasty, including laser-assisted procedures*Participating provider precertification list for Aetna, Pg 14 Original policy
S2080Uvulopalatopharyngoplasty, including laser-assisted procedures*Participating provider precertification list for Aetna, Pg 14 Original policy
33975Ventricular assist devicesParticipating provider precertification list for Aetna, Pg 14 Original policy
33978Ventricular assist devicesParticipating provider precertification list for Aetna, Pg 14 Original policy
33979Ventricular assist devicesParticipating provider precertification list for Aetna, Pg 14 Original policy
33981Ventricular assist devicesParticipating provider precertification list for Aetna, Pg 14 Original policy
33990Ventricular assist devicesParticipating provider precertification list for Aetna, Pg 14 Original policy
33991Ventricular assist devicesParticipating provider precertification list for Aetna, Pg 14 Original policy
33992Ventricular assist devicesParticipating provider precertification list for Aetna, Pg 14 Original policy
33993Ventricular assist devicesParticipating provider precertification list for Aetna, Pg 14 Original policy
92970Ventricular assist devicesParticipating provider precertification list for Aetna, Pg 14 Original policy
81415Whole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
81416Whole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
81417Whole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
81425Whole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
81426Whole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
81427Whole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
0094UWhole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
0214UWhole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
0215UWhole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
0335UWhole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
0336UWhole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
0425UWhole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
0426UWhole genome sequencingParticipating provider precertification list for Aetna, Pg 15 Original policy
J7192Advate antihemophilic factor, human recombinantParticipating provider precertification list for Aetna, Pg 16 Original policy
J7207Adynovate antihemophilic factor [recombinant], PEGylatedParticipating provider precertification list for Aetna, Pg 16 Original policy
J7210Afstyla antihemophilic factor [recombinant], single chainParticipating provider precertification list for Aetna, Pg 16 Original policy
J7186Alphanate antihemophilic factor/von Willebrand factor complex [human]Participating provider precertification list for Aetna, Pg 16 Original policy
J7193AlphaNine SD coagulation factor IX [human]Participating provider precertification list for Aetna, Pg 16 Original policy
J7201Alprolix coagulation factor IX [recombinant], Fc fusion proteinParticipating provider precertification list for Aetna, Pg 16 Original policy
J7214Altuviiio antihemophilic factor [recombinant], Fc fusion proteinParticipating provider precertification list for Aetna, Pg 16 Original policy
J7195BeneFix coagulation factor IX [recombinant]Participating provider precertification list for Aetna, Pg 16 Original policy
J7175Coagadex coagulation factor X [human]Participating provider precertification list for Aetna, Pg 16 Original policy
J7180Corifact factor XIII concentrate [human]Participating provider precertification list for Aetna, Pg 16 Original policy
J7205Eloctate antihemophilic factor [recombinant], Fc fusion proteinParticipating provider precertification list for Aetna, Pg 16 Original policy

Aetna precertification list

The participating-provider examples point at the official list. Open the list itself for the current file, including its effective date.

Aetna participating provider precertification list

Aetna precertification lists

Plan and setting exceptions

Student Health and Allina Health / Aetna are separate from the participating-provider rows above.

Prior authorization forms

Official Aetna form route
Product or planBenefitRoute
Use the plan named on the official form pageMedical and pharmacy forms are listed by AetnaAetna health care professional forms

This page does not reproduce a form and does not list a fax number that was not read from the form page.

Sources

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.

This website uses cookies to ensure you get the best experience on our website. Learn more