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Aetna prior authorization and CPT code lookup, page 31

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
73721Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
73722Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
73723Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
73725Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74150Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74160Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74170Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74174Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74175Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74176Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74177Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74178Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74181Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74182Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74183Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74185Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74261Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74262Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74263Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74712Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
74713Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
75557Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
75559Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
75561Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
75563Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
75565Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
75571Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
75572Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
75573Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
75574Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
75635Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
76380Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
76390Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
77021Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
77022Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
77046Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
77047Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
77048Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
77049Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
77084Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
78608Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
78609Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
78811Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
78812Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
78813Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
78814Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
78815Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
78816Radiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
0609TRadiology imagingParticipating provider precertification list for Aetna, Pg 43 Original policy
0610TRadiology imagingParticipating provider precertification list for Aetna, Pg 43 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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