Amnioinfusion (CPB 0417, reviewed 2026-07-10)
Aetna considers amnioinfusion medically necessary for reducing variable decelerations of the fetal heart rate caused by cord compression during labor, and for intrauterine resuscitation in the setting of a Category II intrapartum fetal heart rate tracing to improve FHR abnormalities before cesarean delivery. Aetna considers amnioinfusion experimental, investigational or unproven for indications including chorioamnionitis, facilitation of external cephalic version, preterm premature rupture of membranes, prevention of meconium aspiration syndrome, prevention of postpartum hemorrhage, prophylactic treatment of oligohydramnios, and treatment of anhydramnios from bilateral renal agenesis. CPT 59070 (transabdominal amnioinfusion, including ultrasound guidance) is covered if selection criteria are met.