Medical necessity review of infertility drugs by Aetna Specialty Pharmacy Guideline Management may be bypassed for infertility ART drugs that are for use with infertility medical procedures if the infertility procedure has been approved for coverage under the member’s Aetna medical benefit plan. During...
ICD10 diagnostic codesthat support medical necessity Lists ofICD10 codesthat do not support medical necessity Comprehensive Code Lookup CrossCoder allows users to search over 16,000 medical service and procedure codes, including: CPT Codes HCPCS Level II ...
Aetna considers pharyngeal and lingual tonsillectomy medically necessary as an isolated procedure in adult OSA where hypertrophied tonsils compromise the airway space. A tonsillectomy is also considered medically necessary with UPPP in members who meet medical necessity criteria for UPPP below. An adenoidec...
Policy Applicable CPT / HCPCS / ICD-10 Codes Background ReferencesPolicyScope of PolicyThis Clinical Policy Bulletin addresses obstructive sleep apnea in children.Medical Necessity Aetna considers the following modalities medically necessary for the diagnosis and treatment of obstructive sleep apnea in ...