Aetna CTA Chest (e.g., pulmonary embolism) prior authorization requirements (2026)
What Aetna generally requires to approve CTA Chest (e.g., pulmonary embolism) (CPT 71275), for Commercial plans. Yes. Aetna generally requires prior authorization for CTA Chest (e.g., pulmonary embolism) (CPT 71275).
Medical-necessity criteria Aetna generally applies
CT angiography of the chest is appropriate (per ACR Appropriateness Criteria for Acute Chest Pain-Suspected Pulmonary Embolism) as first-line imaging when pretest probability is high, or when D-dimer is positive at low/intermediate pretest probability. Document the pretest-probability score and D-dimer.
Situations to verify before submitting
Aetna may not cover CTA Chest (e.g., pulmonary embolism) in these situations. Verify against the current policy rather than assuming a denial:
- {"text":"Low or intermediate pretest probability with a NEGATIVE D-dimer (PE can be safely excluded without imaging per ACR criteria)","source":"ACR Appropriateness Criteria: Acute Chest Pain-Suspected Pulmonary Embolism"}
Source
Advanced imaging PA for Aetna is managed by eviCore. Criteria summarized from ACR Appropriateness Criteria Acute Chest Pain-Suspected Pulmonary Embolism. Source: jacr.org; eviCore radiology program. Last verified 2026-06-12.
Frequently asked questions
Does Aetna require prior authorization for CTA Chest (e.g., pulmonary embolism)?
Yes. Aetna generally requires prior authorization for CTA Chest (e.g., pulmonary embolism) (CPT 71275).
What does Aetna require to approve CTA Chest (e.g., pulmonary embolism)?
CT angiography of the chest is appropriate (per ACR Appropriateness Criteria for Acute Chest Pain-Suspected Pulmonary Embolism) as first-line imaging when pretest probability is high, or when D-dimer is positive at low/intermediate pretest probability. Document the pretest-probability score and D-dimer. Always confirm against the current Aetna policy.
How long does a Aetna prior authorization take?
Turnaround varies by plan and submission method. Check the Aetna portal for current timeframes.
Submitting CTA Chest (e.g., pulmonary embolism) to Aetna?
Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.