Aetna Cardiology Program FAQs

Q: When will this program begin?
A: 8/1/2009

Q: What members will be covered under this program?
A: Aetna NY/northern NJ HMO members. 

• New York: All Aetna patients who are enrolled in HMO-based benefits plans (including Medicare) in the following counties in the greater metropolitan New York market: Bronx, Dutchess, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, Sullivan, Ulster and Westchester.
• New Jersey: All Aetna patients who are enrolled in HMO-based benefits plans (including Medicare) in the following New Jersey counties: Bergen, Essex, Hudson, Hunterdon, Middlesex, Monmouth, Morris, Ocean, Passaic, Somerset, Sussex, Union and Warren.

Q: What are the new cardiology imaging modalities that fall under this program?
A: Stress echocardiography and diagnostic left heart catheterization.

Q: What are the CPT codes that require prior authorization for the cardiology program?
A: The following CPT codes will require pre-certification:

• Nuclear stress: 78460, 78461, 78464, 78465, 78478, 78480
• Cardiac CT: 0145T, 0146T, 0148T, 0150T
• Cardiac PET: 78459, 78491, 78492
• Cardiac MRI: 75557, 75558, 75559, 75560, 75561, 75562, 75563, 75564
• Stress echo: 93350, 93351
• Diagnostic left heart catheterization: 93510, 93511

Q: What are the CareCore National phone and fax numbers for the Aetna Cardiology Program?
A: Phone 888-647-5940 (New Jersey) or 888-622-7329 (New York) or faxed to 888-444-1562.

Q: Is transthoracic echocardiography included on the prior authorization list for the Aetna Cardiology Program effective 8/1/09?
A: No.