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Aetna prior authorization and CPT code lookup, page 26

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
93593Diagnostic cardiology (cardiac rhythm implantable devices, cardiac catheterization)Participating provider precertification list for Aetna, Pg 36 Original policy
93594Diagnostic cardiology (cardiac rhythm implantable devices, cardiac catheterization)Participating provider precertification list for Aetna, Pg 36 Original policy
93595Diagnostic cardiology (cardiac rhythm implantable devices, cardiac catheterization)Participating provider precertification list for Aetna, Pg 36 Original policy
93596Diagnostic cardiology (cardiac rhythm implantable devices, cardiac catheterization)Participating provider precertification list for Aetna, Pg 36 Original policy
93597Diagnostic cardiology (cardiac rhythm implantable devices, cardiac catheterization)Participating provider precertification list for Aetna, Pg 36 Original policy
C9762Diagnostic cardiology (cardiac rhythm implantable devices, cardiac catheterization)Participating provider precertification list for Aetna, Pg 36 Original policy
C9763Diagnostic cardiology (cardiac rhythm implantable devices, cardiac catheterization)Participating provider precertification list for Aetna, Pg 36 Original policy
0742TDiagnostic cardiology (cardiac rhythm implantable devices, cardiac catheterization)Participating provider precertification list for Aetna, Pg 36 Original policy
27091Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27125Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27130Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27132Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27134Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27137Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27138Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27437Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27438Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27440Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27441Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27442Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27443Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27446Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27447Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27486Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27487Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
27488Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
S2118Hip and knee arthroplastiesParticipating provider precertification list for Aetna, Pg 37 Original policy
G0151Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0152Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0153Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0155Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0156Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0157Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0158Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0159Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0160Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0161Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0162Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0299Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0300Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0493Home health careParticipating provider precertification list for Aetna, Pg 37 Original policy
G0494Home health care (Tango only:)Participating provider precertification list for Aetna, Pg 37 Original policy
G0495Home health care (Tango only:)Participating provider precertification list for Aetna, Pg 37 Original policy
G0496Home health care (Tango only:)Participating provider precertification list for Aetna, Pg 37 Original policy
G2168Home health care (Tango only:)Participating provider precertification list for Aetna, Pg 37 Original policy
G2169Home health care (Tango only:)Participating provider precertification list for Aetna, Pg 37 Original policy
58970Infertility program —Participating provider precertification list for Aetna, Pg 38 Original policy
58974Infertility program —Participating provider precertification list for Aetna, Pg 38 Original policy
58976Infertility program —Participating provider precertification list for Aetna, Pg 38 Original policy
76948Infertility program —Participating provider precertification list for Aetna, Pg 38 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.

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