Aetna Coverage for Mammogram

Aetna Coverage for Mammogram

Does Aetna cover mammograms? Aetna considers annual mammography screening a medically necessary preventive service for women aged 40 and older. Annual screening is also considered medically necessary for younger women who are judged to be at high- risk by their primary care physician. Screening mammography for other women is considered experimental and investigational because its…

Aetna Non-covered Lab code list

Aetna Non-covered Lab code list

Aetna plans do not cover laboratory tests that are considered experimental or investigational, even when these studies are ordered by a participating physician. The below listed code are some of the most commonly ordered experimental or investigational lab tests. Homocysteine cardiovascular test (CPT 83090) Lipoprotein (A) (CPT 83695) Immunoassay for tumor antigen, quantitative CA 19-9…

Depression screening – Aetna medical coverage guidelines

Depression screening – Aetna medical coverage guidelines

The Aetna Depression Management Program provides primary care physicians (PCPs) with a one-stop resource to help diagnose and treat Aetna LCD patients with depression age 19 years and older. This program promotes collaboration among PCPs, mental health professionals and Aetna’s care management team. Its focus is on proactive assessment and early intervention, with the goals…

Aetna Reimbursement for Chiropractic services

Aetna Reimbursement for Chiropractic services

Aetna considers chiropractic services medically necessary when all of the following criteria are met: The member has a neuromusculoskeletal disorder; and The medical necessity for treatment is clearly documented; and Improvement is documented within the initial 2 weeks of chiropractic care. If no improvement is documented within the initial 2 weeks, additional chiropractic treatment is…