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Aetna Medical Policy Updates – April 2024
Click here to view the Aetna Medical Policy Updates »
April 2024 Aetna Medical Policy Updates:
- Abatacept (Orencia)
- Ablation of Hepatic Lesions
- Acoustic Pharyngometers and SNAP Testing System
- Acupuncture
- Adalimumab (Humira)
- Ado-trastuzumab Emtansine (Kadcyla)
- Allograft Transplants of the Extremities
- Alpha 1-Antitrypsin Inhibitor Therapy
- Antineoplaston Therapy and Sodium Phenylbutyrate
- Apnea Monitors for Infants
- Aural Rehabilitation
- Autologous Chondrocyte Implantation
- Back Pain – Invasive Procedures
- Back Pain – Non Invasive Treatments
- Benralizumab (Fasenra)
- Botulinum Toxin
- BRCA Testing, Prophylactic Mastectomy, and Prophylactic Oophorectomy
- Breast Reconstructive Surgery
- Bunionectomy
- Carbon Dioxide Laser for Actinic Lesions and Other Selected Indications
- Cardiac Catheter Ablation and Radioablation
- Cardiac CT, Coronary CT Angiography, Calcium Scoring and CT Fractional Flow Reserve
- Cemiplimab (Libtayo)
- Certolizumab Pegol (Cimzia)
- Chiropractic Services
- Chronic Pain Programs
- Chronic Vertigo
- Ciltacabtagene Autoleucel (Carvykti)
- Color-Flow Doppler Echocardiography in Adults
- Contact Lenses and Eyeglasses
- Cosmetic Surgery
- Daratumumab
- Deep Brain Stimulation
- Dental Services and Oral and Maxillofacial Surgery: Coverage Under Medical Plans
- Dexamethasone Suppression Test for Diagnosing Depression
- Diabetes Tests, Programs and Supplies
- Distraction Osteosynthesis
- Electrical Stimulation for Pain
- Enfuvirtide (Fuzeon)
- Etanercept
- Etranacogene Dezaparvovec-drlb (Hemgenix)
- Evoked Potential Studies
- Extracorporeal Photochemotherapy (Photopheresis)
- Fam-trastuzumab Deruxtecan-nxki (Enhertu)
- Fecal Incontinence
- Fetal Fibronectin, Inflammatory Biomarkers, and Salivary Hormone Testing for Preterm Labor
- Fiberoptic Endoscopic Evaluation of Swallowing (FEES)/Fiberoptic Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST) and Laryngopharyngeal Endoscopic Esthesiometer (LPEER)
- Fibroid Treatment
- Fluocinolone Acetonide Intra-vitreal Implant (Retisert, Yutiq and Iluvien)
- Gait Analysis and Electrodynogram
- Gastroesophageal Reflux Disease (GERD): Treatment Devices
- Gender Affirming Surgery
- General Anesthesia and Monitored Anesthesia Care for Oral and Maxillofacial Surgery and Dental Services
- Genetic Testing
- Golimumab (Simponi and Simponi Aria)
- Graves’ Ophthalmopathy Treatments
- Grenz Ray Therapy for Skin Disorders
- Grid Monitoring and Intraoperative Electroencephalography
- Guselkumab (Tremfya)
- Hair Analysis
- Helicobacter Pylori Infection Testing
- Hematopoietic Colony-Stimulating Factors (CSFs)
- Hemodialysis for Schizophrenia
- High-Frequency Pulsed Electromagnetic Stimulation
- Hip Arthroplasty
- Hippotherapy
- HIV Drug Susceptibility and Resistance Tests
- Holter Monitors
- Home Births
- Home Health Aides
- Home Uterine Activity Monitoring
- Hospitalization for the Initiation of Ketogenic Diet for the Treatment of Intractable Seizures
- Hyperbaric Oxygen Therapy (HBOT)
- Idecabtagene Vicleucel (Abecma)
- Inflammatory Bowel Disease: Serologic Markers and Pharmacogenomic and Metabolic Assessment of Thiopurine Therapy
- Infliximab
- Injectable Medications
- Inpatient Admission Prior to Surgery (Preop Days)
- Intensive Cardiac Rehabilitation Programs
- Interferons
- Intervertebral Disc Prostheses
- Intraoperative Electromyographic Monitoring
- Intra-oral Appliances for Headaches and Trigeminal Neuralgia
- Iontophoresis
- Ipilimumab (Yervoy)
- Lung Volume Reduction Surgery
- Lyme Disease and other Tick-Borne Diseases
- Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) of the Spine
- Magnetic Resonance Imaging (MRI) of the Extremities
- Magnetic Resonance Spectroscopy (MRS)
- Magnetic Source Imaging/Magnetoencephalography
- Maze Procedure
- Mecasermin (Increlex)
- Mepolizumab (Nucala)
- Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT)
- Neonatal Hyperbilirubinemia
- Noninvasive Down Syndrome Screening
- Non-invasive Negative Pressure Ventilation: Body Ventilators and Poncho Wrap
- Obesity Surgery
- Obinutuzumab (Gazyva)
- Obstructive Sleep Apnea in Adults
- Obstructive Sleep Apnea in Children
- Occupational Therapy
- Open Air, Low Field Strength, and Positional Magnetic Resonance Imaging (MRI) Units
- Osteoarthritis of the Knee: Selected Treatments
- Oxygen
- Pedobarography
- Pertuzumab (Perjeta)
- Pharmacogenetic and Pharmacodynamic Testing
- Phonophoresis
- Phototherapy and Photochemotherapy (PUVA) for Skin Conditions
- Plantar Fasciitis Treatments
- Pool Therapy, Aquatic Therapy or Hydrotherapy
- Preconceptional Sex Selection Techniques
- Prenatal Care Provided by Primary Care Physicians
- Prolotherapy and Sclerotherapy
- Pulmonary Rehabilitation
- Radiofrequency Tumor Ablation
- RET Proto-Oncogene Testing
- Risankizumab-rzaa (Skyrizi)
- Routine Foot Care
- Scalp Cooling (Hypothermia) to Prevent Hair Loss During Chemotherapy
- Secukinumab (Cosentyx)
- Sensory and Auditory Integration Therapy
- Skin and Soft Tissue Substitutes
- Somatostatin Analogs
- Speech Therapy
- Spinal Cord Stimulation
- Stereotactic Cingulotomy and Capsulotomy
- Surface Scanning and Macro Electromyography
- Surgical Treatments to Control Drooling (Sialorrhea)
- Temporomandibular Disorders
- Thalamotomy
- Thoracoscopic Sympathectomy
- Tilt Table Testing
- Total Body Photography, Dermoscopy and Other Selected Noninvasive Dermatologic Tests
- Transcatheter Closure of Septal Defects
- Transrectal Ultrasound
- Trastuzumab (Herceptin and biosimilars), Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)
- Tumor Chemosensitivity Assays
- Tumor Markers
- Tumor Scintigraphy
- Ultra Rapid Detoxification (UROD)
- Ultrasound for Pregnancy
- Ultrasound Guidance – Selected Indications
- Ustekinumab (Stelara)
- Varicella and Herpes Zoster Vaccines
- Verteporfin (Visudyne) Photodynamic Therapy
- Videostroboscopy
- Viscosupplementation
- Visual Perceptual Training and Vision Restoration Therapy
- Xerostomia: Selected Treatments
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