We’ve chosen certain clinical guidelines to help our providers get members high-quality, consistent care that uses services and resources effectively. Explore our provider manuals to find resources about Aetna policy guidelines that explain how to work with us. Medically Necessary Kidney Transplantation Aetna considers kidney transplantation medically Additional Information Clinical Policy Bulletin Notes Aetna considers the following qualitative polymerase chain reaction (PCR) testing medically necessary (not an all-inclusive list): Visit our Formularies and Pharmacy Clinical Policy Bulletins page to view: Commercial pharmacy plan drug guides with new-to-market drugs we add monthly Clinical policy bulletins with the What's New in the Clinical Policy Bulletins Guidelines for Determining Coverage | Clinical Policy Bulletins | Medicare | Payment Policy Please select your segment Additions, Revisions, Additional Information Clinical Policy Bulletin Notes Endometrial biopsy (sampling) for histological tissue examination in the diagnostic evaluation of abnormal uterine bleeding in women Policy Scope of Policy This Clinical Policy Bulletin addresses endometrial cancer screening, diagnosis, and prognosis. Medical Necessity Qualitative Polymerase Chain I n f e c t i o u s D i s e a s e s : S e l e c t e d T e s t s Clinical Policy Bulletins Medical Clinical Policy Bulletins Number: 1008 7DEOH 2I &RQWHQWV Policy Applicable CPT / HCPCS / ICD Mercy Care uses clinical criteria from the Aetna Medical Clinical Policy Bulletins when reviewing requests for prior authorization. Below you’ll find added information and links on how Aetna® and Allina Health | Aetna MA plans comply with these regulations. I. Medical Necessity Aetna considers the following medically necessary for the management of vaginitis: Policy Scope of Policy This Clinical Policy Bulletin addresses services for the management of infertility for commercial medical plans. Medical Necessity Aetna considers the following medically necessary: Policy Scope of Policy This Clinical Policy Bulletin addresses multiple sclerosis for commercial medical plans. Dosage and Administration Note: Approvals may be subject to dosing limits in Clinical practice guidelines summarize evidence-based management and treatment options for specific diseases or conditions. NEW POLICY UPDATES CLINICAL PAYMENT, CODING AND POLICY CHANGES We regularly augment our clinical, payment and coding policy positions as part of Clinical practice guidelines summarize evidence-based management and treatment options for specific diseases or conditions. Aetna medical directors are available 24 hours a day for Clinical practice guidelines summarize evidence-based management and treatment options for specific diseases or conditions. For Medicare criteria, see Medicare Part B Criteria. Pharmacy Clinical Policy Bulletin can be requested by calling Aetna’s Pharmacy Management at 1-800-670-3566. We may encourage you to access Proprietary Diagnosis of Vaginitis - Medical Clinical Policy Bulletins | Aetna Page 4 of 25 vaginal candidiasis. Policy Scope of Policy This Clinical Policy Bulletin addresses sinus surgeries. Did you receive a letter based on Aetna clinical criteria? November 2024: Aetna posts Medical Policy Updates. Track all recent medical policy updates with Policy Alerts. Chiropractic Services- CPB-0107 Chlamydia Trachomatis – Screening and Diagnosis- CPB-0433 Cholecystokinin Cholescintigraphy- CPB-0266 Chronic Fatigue Syndrome - CPB 0369 Chronic 0433-Chlamydia Trachomatis – Screening and Diagnosis 0434-Therapeutic Chairs 0435 Viscocanalostomy and Canaloplasty 0437-Speech Generating Devices 0438 Obsolete and Explore the medical clinical policy bulletins that Aetna uses to decide which services and procedures we will cover. Note: Most Aetna HMO and QPOS plans exclude coverage of surgical operations, procedures, or treatment of obesity Policy Scope of Policy This Clinical Policy Bulletin addresses the diagnosis of vaginitis. Other tests, such as Scope of Policy This Clinical Policy Bulletin addresses chlamydia trachomatis - screening and diagnosis. Medical Necessity Aetna considers endoscopic sinus surgery (ESS) medically necessary for any of the following See also Aetna Non-Medicare Prescription Drug Plan Specialty Pharmacy Clinical Policy Bulletins. Policy Scope of Policy This Clinical Policy Bulletin addresses services for the management of infertility for commercial medical plans. Note: Requires Clinical practice guidelines summarize evidence-based management and treatment options for specific diseases or conditions. . Real-time ΗSV РСR assays have emerged as the most sensitive method to confirm HЅV infection in clinical specimens obtained from mucocutaneous sites. Clinical practice guidelines summarize evidence-based management and treatment options for specific diseases or conditions. Medical Necessity Aetna considers the following indications as medically These bulletins state our policy about the medical necessity or investigational status of medical technologies and other services to help with coverage decisions. Policy Scope of Policy This Clinical Policy Bulletin addresses qualitative and quantitative polymerase chain reaction (PCR) testing. While the presence of clue cells to diagnose BV is considered a Policy Scope of Policy This Clinical Policy Bulletin addresses kidney transplantation. Additional Information Clinical Policy Bulletin Notes significantly improve, develop or restore physical functions lost or impaired as a result of a disease, injury or surgical procedure, and Scope of Policy This Clinical Policy Bulletin addresses drug testing in pain management Wellness and other rewards You may be eligible to earn rewards for completing certain activities that improve your health, coverage, and experience with us. One note of caution: Aetna’s clinical policy bulletins provide a scientific and clinical basis on which Aetna medical directors can evaluate the status and medical necessity of Scope of Policy This Clinical Policy Bulletin addresses obesity surgery.
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