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March 2016

Prior Authorization Changes

Beginning on July 1st, 2016 prior authorization will be required for the following:

 
Capsule Endoscopy
CPT Codes
  • 0355T
  • 91110
  • 91111
Alternatives to this procedure include:
Barium Enema
Colonoscopy
CT or MRI Enterography
Device-assisted Enteroscopy
Esophagogastroduodenoscopy
Nuclear Medicine Gastrointestinal Blood Loss Study
UGI Barium Studies

Implantable Defibrillators 
HCPCS Codes
  • C1721
  • C1722
  • C1777
  • C1882
  • C1895
  • C1896
  • C1899
Temporary Code:
G0448

Surgery Related Codes:
33270, 33271, 33249
 

Sincerely,
 
Aetna Better Health of Ohio
If you have questions or concerns please call us at 1-855-364-0974.



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