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Aetna Medical Policy Updates – December 2023
Click here to view the Aetna Medical Policy Updates »
December 2023 Aetna Medical Policy Updates:
- Acute Ischemic Stroke Treatments
- ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP)
- Age-Related Macular Degeneration
- Alzheimer’s Disease: Experimental Treatments
- Antepartum Fetal Surveillance
- Artificial Retina and Artificial Iris
- Asparaginase Erwinia chrysanthemi (Erwinaze)
- Aural Rehabilitation
- Automated Audiometry
- Axial Lumbar Interbody Fusion (AxiaLIF)
- Back Pain – Invasive Procedures
- Beremagene Geperpavec-svdt (Vyjuvek) – CPB 1033
- Betibeglogene Autotemcel (Zynteglo)
- Bezlotoxumab (Zinplava)
- Blood and Adipose Product Injections for Selected Indications
- BRCA Testing, Prophylactic Mastectomy, and Prophylactic Oophorectomy
- Breast Reconstructive Surgery
- Breast Reduction Surgery and Gynecomastia Surgery
- Brexucabtagene Autoleucel (Tecartus)
- Carotid Sinus Stimulation for Hypertension
- Cetuximab (Erbitux)
- Chiari Malformation Decompression Surgery
- Computerized Wheeze Detectors
- Copanlisib (Aliqopa)
- Dengue Vaccine
- Devices for Post-Operative Use Following Endoscopic Sinus Surgery
- Diabetic Neuropathy: Selected Treatments
- Electric Tumor Treatment Fields
- Electromagnetic Navigation-Guided Bronchoscopy
- Endometrial Cancer Screening and Diagnosis
- Epcoritamab-bysp (Epkinly) – CPB 1034
- Epidural Patching
- Epiretinal Radiation Therapy
- Eptinezumab-jjmr (Vyepti)
- Esophageal Doppler Monitoring
- Evoked Potential Studies
- Extended Ophthalmoscopy
- Face Transplantation
- Fluocinolone Acetonide Intra-vitreal Implant (Retisert, Yutiq and Iluvien)
- Glofitamab-gxbm (Columvi) – CPB 1036
- Golimumab (Simponi and Simponi Aria)
- Golimumab (Simponi and Simponi Aria) [Medicare]
- Hand Transplantation
- Hematopoietic Cell Transplantation for Myelodysplastic Syndrome
- Hematopoietic Cell Transplantation for Solid Tumors in Adults
- Hematopoietic Cell Transplantation for Waldenstrom Macroglobulinemia
- Hematopoietic Colony-Stimulating Factors (CSFs)
- Hematopoietic Colony-Stimulating Factors (CSFs) [Medicare]
- Hepatitis Screening
- Home Behavioral Healthcare Services
- Home Hemoglobin Testing Devices
- Homocysteine Testing
- Hospital Beds and Accessories
- Implantable Left Atrial Hemodynamic Monitor
- In Vivo Analysis of Gastro-Intestinal and Urothelial Lesions
- Infectious Diseases: Selected Tests
- Infertility
- Internal Fixation of Rib Fracture
- Interstitial Laser Therapy
- Intra-coronary Hyperoxemic Therapy
- Intraoperative Electromyographic Monitoring
- Intravascular Ultrasound
- Irreversible Electroporation (NanoKnife)
- Leadless Cardiac Pacemaker
- Levoleucovorin (Fusilev and Khapzory)
- Luxturna (Voretigene Neparvovec-rzyl)
- Magnetic Resonance Spectroscopy (MRS)
- Mosunetuzumab-axgb (Lunsumio)
- Neurogenic Bladder: Selected Treatments
- Nirsevimab-alip (Beyfortus) – CPB 1038
- Non-Invasive Fetal Membranes Rupture Tests
- Novel Injection Methods
- Nusinersen (Spinraza)
- Obstructive Sleep Apnea in Adults
- Ocriplasmin (Jetrea)
- Ofatumumab (Arzerra)
- Omidubicel-onlv (Omisirge) – CPB 1032
- Ostomy Supplies
- Pediatric Intensive Feeding Programs
- Pegaspargase (Oncaspar)
- Pegcetacoplan Intravitreal Injection (Syfovre)
- Peripheral Atherectomy and Thrombectomy Devices
- Peripheral Vascular Stents
- Pharmacogenetic and Pharmacodynamic Testing
- Phototherapy and Photochemotherapy (PUVA) for Skin Conditions
- Pneumococcal Vaccine
- Premenstrual Syndrome and Premenstrual Dysphoric Disorder
- Procalcitonin (PCT)
- Pudendal Nerve Decompression
- Pulse Oximetry and Capnography for Home Use
- Radiofrequency Ablation of the Renal Sympathetic Nerve
- Radiostereometric Analysis for Migration and Wear of Orthopedic Implants
- Rheumatic Diseases: Selected Tests
- Romiplostim (Nplate)
- Rozanolixizumab-noli (Rystiggo) – CPB 1035
- Single Photon Emission Computed Tomography (SPECT)
- Speech Therapy
- Spinal Surgery: Laminectomy and Fusion
- Stem Cells for Hematopoietic Cell Transplant
- Sutimlimab-jome (Enjaymo)
- Testosterone Cypionate Injection (Depo-Testosterone)
- Transcatheter Aortic Valve Implantation
- Transplant Immune Cell Function Assays
- Tumor Scintigraphy
- Valoctocogene Roxaparvovec-rvox (Roctavian) – CPB 1037
- Vascular Endothelial Growth Factor Inhibitors for Ocular Indications
- Vascular Endothelial Growth Factor Inhibitors for Ocular Indications [Medicare]
- Vitiligo
- Vulvodynia and Vulvar Vestibulitis Treatments
- Wheelchairs and Power Operated Vehicles (Scooters)
- Winged Scapula
- Ziv-Aflibercept (Zaltrap)
Click here to view the Aetna Medical Policy Updates »
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