Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases. Supplemental information and guidance for vaccination providers regarding use of 9-valent HPV vaccine. CS HCVG-15-PTT-107. Atlanta, GA: CDC; November 29, 2016. Centers for Disease Control ...
Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does ...
For members with such a plan benefit, specific nutritional support is considered to be a medical item only when it is administered enterally (i.e., by feeding tube) or parenterally (i.e., by intravenous administration) where the member has either (a) a permanentFootnote1* visited non-func...
Women may be able to breastfeed adopted infants through induced lactation. The process involves nipple stimulation with use of an electric breast pump beginning about two months before the adoptive mother expects to begin breast-feeding. In addition, hormonal therapy, such as supplemental estrogen or...
This policy statement supplements plan coverage language by identifying procedures that Aetna considers medically necessary despite cosmetic aspects, and other cosmetic procedures that Aetna considers not medically necessary. Please note that, while this policy statement addresses many common procedures, it do...
M0249 Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-hyphen19 who are receiving systemic corticosteroids and require supplemental oxygen, non-hypheninvasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (...
The supplemental modules focus on specific topics (e.g., relationship skills, living with hepatitis C). Modules may typically take 10 to 20 minutes to complete. The reSET app is supported on a mobile operating system (e.g., smartphone or tablet). A prescription is required from a licensed...
Note: Except for Medicare plans and where coverage is mandated by state law, generally coverage for diabetic supplies would be provided under a pharmacy rider and not as part of medical coverage. Certain diabetic supplies may also be covered under the medical plan if no pharmacy or diabetic supp...
Precertification of immune globulin human intramuscular injection (IGIM) (GamaSTAN) is required of all Aetna participating providers and members in applicable plan designs. For precertification of immune globulin human intramuscular injection (IGIM) (GamaSTAN), call (866) 752-7021 (commercial) or ...
Note: Coverage of GnRH antagonists for this indication is limited to plans that cover advanced reproductive technologies. Please check benefit plan descriptions for details. Degarelix (Firmagon) Criteria for Initial Approval Aetna considers degarelix (Firmagon) medically necessary for the treatment of prost...