Aetna Ventricular Assist Devices prior authorization requirements (2026)

What Aetna generally requires to approve Ventricular Assist Devices (CPT 33975, 33978, 33979, 33981, 33990, 33991, 33992, 33993, 92970), for Commercial plans. Yes. Aetna generally requires prior authorization for Ventricular Assist Devices (CPT 33975, 33978, 33979, 33981, 33990, 33991, 33992, 33993, 92970).

General reference compiled from public sources, last verified 2026-05-06. This is not a coverage determination or medical advice. Always confirm current requirements with Aetna before submitting.

Medical-necessity criteria Aetna generally applies

Medical necessity review required

Diagnoses that commonly support medical necessity

ICD-10-CM diagnoses frequently associated with medical necessity for Ventricular Assist Devices. Confirm the covered diagnosis list against the current Aetna policy.

I50.84End stage heart failureI50.9Heart failure, unspecified

Commonly required documentation

  • Complete medical records including cardiac evaluation

How to submit

  • Method: portal
  • Typical turnaround: about 3 days

Source

Standard precertification process applies Last verified 2026-05-06.

Frequently asked questions

Does Aetna require prior authorization for Ventricular Assist Devices?

Yes. Aetna generally requires prior authorization for Ventricular Assist Devices (CPT 33975, 33978, 33979, 33981, 33990, 33991, 33992, 33993, 92970).

What does Aetna require to approve Ventricular Assist Devices?

Medical necessity review required Always confirm against the current Aetna policy.

How long does a Aetna prior authorization take?

Aetna typically decides Ventricular Assist Devices requests in about 3 days. Timeframes vary; check the payer portal.

Submitting Ventricular Assist Devices 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.

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Other Aetna prior authorization requirements

ACL ReconstructionAnterior Cervical Discectomy and FusionArthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairArtificial Intervertebral Disc Surgery (Cervical Spine)Artificial Intervertebral Disc Surgery (Lumbar Spine)Autologous Chondrocyte ImplantationBunionectomy (Hallux Valgus Correction)Cervical, Lumbar and Thoracic Laminectomy and/or Laminotomy ProceduresChiari Malformation Decompression SurgeryCochlear Device and/or ImplantationCT Abdomen and Pelvis with contrastCTA Chest (e.g., pulmonary embolism)

Related guides

Why was my prior authorization denied? Top reasons and how to fix eachHow to write a prior authorization appeal that cites policy