Aetna

CT

PAD Yes Effective 9/1/2023

CCTA the severity of coronary artery disease; data preparation and transmission, analysis of fluid dynamics and simulated

CCTA angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess

CCTA

CCTA

CID imaging supervision and interpretation, when performed; complete system (includes electrode and generator

CID

CID

CID

CID

MR localization of discogenic pain (cervical, thoracic, or lumbar); acquisition of single voxel data, per disc, on biomarkers

MR

MR postprocessing for algorithmic analysis of biomarker data for determination of relative chemical differences between

MR

CRID Yes 1/1/2021 Addition

CCTA Effective 9/1/2021 AMA Additions Investigational

CCTA

CCTA

CCTA

CT Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast material

CT Computed tomography, breast, including 3D rendering, when performed, unilateral; with contrast material(s)

CT

CT Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast material(s)

CT Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s)

CT

CT (CTA) Investigational

CT (CTA) Investigational

CT (CTA) angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic Investigational

CT (CTA) Investigational

NUC CARD exercise or pharmacologic stress, and at rest, when performed (List separately in addition to code for primary

CID Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial

CID Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular

CID Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular

CID Insertion of pacemaker pulse generator only; with existing single lead

CID Insertion of pacemaker pulse generator only; with existing dual leads

CID removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse

CID Insertion of pacemaker pulse generator only; with existing multiple leads

CID pacemaker or implantable defibrillator pulse generator (including revision of pocket, removal, insertion, and/or

CID defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (List separately in addition to code Yes Add-On

CID Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system

CID Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system

CID

CID Insertion of implantable defibrillator pulse generator only; with existing dual leads

CID Insertion of implantable defibrillator pulse generator only; with existing multiple leads

CID Insertion of implantable defibrillator pulse generator only; with existing single lead

CID Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber

CID

CID

CID

CID including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination,

CID Insertion of subcutaneous implantable defibrillator electrode

CID Removal of subcutaneous implantable defibrillator electrode

CID Repositioning of previously implanted subcutaneous implantable defibrillator electrode

CID (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or

CID Transcatheter removal of permanent leadless pacemaker, right ventricular

CID including deployment and calibration of the sensor, right heart catheterization, selective pulmonary catheterization,

PAD Yes Effective 9/1/2023

PAD Yes Effective 9/1/2023

PAD

PAD transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in

PAD Yes Effective 9/1/2023

PAD Yes Effective 9/1/2023

PAD Yes Effective 9/1/2023

PAD Yes Effective 9/1/2023

PAD Yes Effective 9/1/2023

PAD Yes Effective 9/1/2023

PAD Yes Effective 9/1/2023

PAD Yes Effective 9/1/2023

PAD

PAD atherectomy, includes angioplasty within the same vessel, when performed (List separately in addition to code for

PAD transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in

PAD transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed (List

MR Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)

CT Computed tomography, head or brain; without contrast material

CT Computed tomography, head or brain; with contrast material(s)

CT Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections

CT Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material

CT Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)

CT

CT Computed tomography, maxillofacial area; without contrast material

CT Computed tomography, maxillofacial area; with contrast material(s)

CT

CT Computed tomography, soft tissue neck; without contrast material

CT Computed tomography, soft tissue neck; with contrast material(s)

CT Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections

CT

CT

MR Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)

MR Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)

MR

MR Magnetic resonance angiography, head; without contrast material(s)

MR Magnetic resonance angiography, head; with contrast material(s)

MR

MR Magnetic resonance angiography, neck; without contrast material(s)

MR Magnetic resonance angiography, neck; with contrast material(s)

MR

MR Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material

MR Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)

MR

MR

MR

CT Computed tomography, thorax, diagnostic; without contrast material

CT Computed tomography, thorax, diagnostic; with contrast material(s)

CT

CT Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) Yes 1/1/2021 Addition

CT

MR

MR

MR

MR Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)

CT Computed tomography, cervical spine; without contrast material

CT Computed tomography, cervical spine; with contrast material

CT Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections

CT Computed tomography, thoracic spine; without contrast material

CT Computed tomography, thoracic spine; with contrast material

CT Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections

CT Computed tomography, lumbar spine; without contrast material

CT Computed tomography, lumbar spine; with contrast material

CT Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections

MR Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material

MR Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)

MR Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material

MR Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)

MR Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material

MR Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)

MR

MR

MR

MR Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)

CT

CT Computed tomography, pelvis; without contrast material

CT Computed tomography, pelvis; with contrast material(s)

CT Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections

MR Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)

MR Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)

MR

MR Magnetic resonance angiography, pelvis, with or without contrast material(s)

CT Computed tomography, upper extremity; without contrast material

CT Computed tomography, upper extremity; with contrast material(s)

CT Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections

CT

MR Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)

MR Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)

MR

MR Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)

MR Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)

MR

MR Magnetic resonance angiography, upper extremity, with or without contrast material(s)

CT Computed tomography, lower extremity; without contrast material

CT Computed tomography, lower extremity; with contrast material(s)

CT Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections

CT

MR Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)

MR Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)

MR

MR Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material

MR Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)

MR

MR Magnetic resonance angiography, lower extremity, with or without contrast material(s)

CT Computed tomography, abdomen; without contrast material

CT Computed tomography, abdomen; with contrast material(s)

CT Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections

CT

CT

CT Computed tomography, abdomen and pelvis; without contrast material

CT Computed tomography, abdomen and pelvis; with contrast material(s)

CT

MR Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)

MR Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)

MR

MR Magnetic resonance angiography, abdomen, with or without contrast material(s)

CT Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material

CT

CT Computed tomographic (CT) colonography, screening, including image postprocessing

MR

MR Yes Add-On

MR Cardiac magnetic resonance imaging for morphology and function without contrast material;

MR Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging

MR

MR

MR Yes Add-On

CT Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium

CT

CT congenital heart disease (including 3D image postprocessing, assessment of left ventricular [LV] cardiac function, right

CT including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac Yes Add-On

CCTA set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified

CT

CT Computed tomography, limited or localized follow-up study

MR Magnetic resonance spectroscopy

MRI Magnetic resonance (eg, vibration) elastography

MRI Unlisted MRI Procedure

MR

MR Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation

BMRI Magnetic resonance imaging, breast, without contrast material; unilateral

BMRI Magnetic resonance imaging, breast, without contrast material; bilateral

BMRI

BMRI

MR Magnetic resonance (eg, proton) imaging, bone marrow blood supply

CPET motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography

CPET ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently

CPET ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently

CPET (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial

CPET (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial

CPET Investigational Additions

Nuc Card motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest

Nuc Card motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at

Nuc Card

Nuc Card gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or

Cardiac

Nuc Card Myocardial Infarction Scan

Nuc Card Heart Infarct Image Ejection Fraction

Nuc Card Heart Infarct Image 3D SPECT

Nuc Card Cardiac Bloodpool Img, Single

Nuc Card Cardiac Bloodpool Img, Multi

Nuc Card Heart First Pass Single

Nuc Card Cardiac Blood Pool Imaging -- Multiple

Cardiac

Cardiac

Nuc Card Cardiac Blood Pool Imaging , SPECT

Nuc Card Yes Add-On

PET Brain imaging, positron emission tomography (PET); metabolic evaluation

PET Brain imaging, positron emission tomography (PET); perfusion evaluation

PET Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck)

PET Positron emission tomography (PET) imaging; skull base to mid-thigh

Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement 1/1/2019 - AMA

PET

PET

PET

Cardiac performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced

Cardiac performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced

Heart Catheterization Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed

Heart Catheterization

Heart Catheterization

Heart Catheterization

Heart Catheterization angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary,

Heart Catheterization

Heart Catheterization

Heart Catheterization angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s)

Heart Catheterization

Heart Catheterization angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural

Heart Catheterization angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural

Heart Catheterization

Heart Catheterization

Heart Catheterization

Heart Catheterization

Heart Catheterization

MRA MRA Abdomen with contrast redirect to

MRA MRA Abdomen without contrast redirect to

MRA MRA Abdomen with and w/o contrast redirect to

MRI MRI Breast with contrast, unilateral redirect to

MRI MRI Breast with and without contrast, unilateral redirect to

MRI MRI Breast Bilateral with contrast redirect to

MRI MRI Breast Bilateral with and without contrast redirect to

MRA MRA chest with contrast (excluding myocardium) redirect to

MRA MRA chest without contrast (excluding myocardium) redirect to

MRA MRA chest with and without contrast (excluding myocardium) redirect to

MRA MRA lower extremity with contrast redirect to

MRA MRA lower extremity without contrast redirect to

MRA MRA lower extremity with and without contrast redirect to

MRA MRA pelvis with contrast redirect to

MRA MRA pelvis without contrast redirect to

MRA MRA pelvis with and without contrast redirect to

MR

MR

MR Magnetic source imaging

MR Magnetic resonance cholangiopancreatography (mrcp)

MR Magnetic resonance imaging (mri), low-field

PET redirect to

CT Electron beam computed tomography (also known as ultrafast ct, cine ct)