CommercialCoverageHigh impact
Magnesium Sulfate Injections and Terbutaline Pump for Preterm Labor (CPB 0468, reviewed 2026-07-17)
Aetna·OB-GYN, Pharmacy·Pharmacy
Effective date
Jul 17, 2026
We identified it
Aug 16, 2026
Summary
Aetna has classified magnesium sulfate injections (J3475) and terbutaline pump therapy as experimental, investigational, or unproven for preterm labor management. Magnesium sulfate injections are now NON-COVERED for ICD-10 codes O60.02-O60.03. Terbutaline pump codes (E0779, E0780, E0781) and related administration codes remain covered only if selection criteria are met, but the clinical evidence does not support their use for maintenance therapy.
Action Required
By 2026-07-17: Billing team must update claims processing system to deny or redirect claims for J3475 (magnesium sulfate injection) when billed with ICD-10 codes O60.02-O60.03 (preterm labor without delivery). Flag all pending and future orders for magnesium sulfate tocolysis for manual review and denial per Aetna policy. Update coding guidance to providers: terbutaline pump codes (E0779, E0780, E0781) and administration codes (99601, 99602, S9208, S9349) require documented selection criteria to be covered; claims lacking documentation will be denied. Remove magnesium sulfate from preterm labor treatment protocols in EMR templates. Training required for billing staff, providers, and prior authorization team on the experimental/unproven classification.