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AetnaAll Plans · Coverage · Radiology · Ophthalmology, Radiology, NeurologyMedium impact

Optic Nerve and Retinal Imaging Methods (CPB 0344, reviewed 2026-10-20)

Effective date
Not stated in the notice
Identified
Oct 23, 2026

Summary

Aetna's Clinical Policy Bulletin 0344 covers optic nerve and retinal imaging methods. Aetna considers these methods medically necessary for documenting the appearance of the optic nerve head and retina in listed diagnoses, including glaucoma, glaucoma suspects, diabetic retinopathy and age-related macular degeneration, and considers OCT angiography (OCTA) medically necessary as an alternative to intravenous fluorescein angiography (IVFA) for listed conditions. Aetna considers routine screening of asymptomatic persons for glaucoma and other retinal diseases, and OCTA for diagnosing and monitoring glaucoma, experimental, investigational or unproven. The policy history lists a last review date of 10/20/2026.

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What to do

Action · 6 steps
01Billing team: Do not bill optic nerve imaging for glaucoma more than once per year, since the source considers that not medically necessary.
02Do not bill both OCTA and IVFA for the same indication, or both OCT and OCTA for the same indication, since the source considers that not medically necessary.
03Do not schedule or bill the uses the source lists as experimental, investigational or unproven, including routine screening of asymptomatic persons for glaucoma and other retinal diseases, OCTA for diagnosing and monitoring glaucoma, and remote OCT monitoring.
04Do not bill CPT 0469T, 0604T, 0605T or 0606T for indications the CPB lists as not covered.
05Before starting chloroquine, hydroxychloroquine or vigabatrin therapy, complete a baseline optic nerve and retinal imaging study, which the source considers medically necessary.
06Annual screening should begin after 5 years of use, or sooner with unusual risk factors.

Codes mentioned

921339213492137

Original notice

Optic Nerve and Retinal Imaging Methods (CPB 0344, reviewed 2026-10-20)
aetna.com · Always check the source before changing claims.
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Related changes

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Related policy hubs

Aetna policiesOphthalmologyRadiologyNeurologyCode 92133Code 92134Code 92137

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