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Changes to 2011 Aetna Precertification List
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The following changes to Aetna's precertification list will take effect on January 1, 2011:
Additions:
- Negative pressure wound therapy
- Infertility drugs
- Hereditary angioedema drugs
- Enzyme replacement drugs
- Pulmonary arterial hypertension drugs
- Osteoporosis drugs
- Boniva®, Miacalcin® and Reclast®
- Zometa®, Prolia® and pamidronate (for osteoporosis indications only)
To precertify the drugs listed above, call 1-866-503-0857 or fax a Medication Request Form to 1-888-267-3277. Obtain forms by logging in to Aetna's secure provider website via NaviNet. After logging in, select "Aetna Support Center" from the Aetna Plan Central home page, then "Forms Library" and "Pharmacy Forms." Newly approved drugs administered by injection or infusion may also be subject to precertification.
Modifications:
- Medical injectables
- Immunoglobulins - parenteral administration (intravenous (IV), subcutaneous (SubQ) and\or intramuscular (IM))
Deletions (including associated codes):
- Somatosensory evoked potential studies (95925, 95926, 95927)
- Other lab studies (0085T)
- Hair transplant (15775, 15776)
- Adrenal tissue transplant (S2103)
Requests for precertification must be received before rendering services. Failure to contact Aetna for precertification will relieve Aetna or employers and members from financial liability for the applicable services.
