E0755, Electronic salivary reflex stimulator (intra-oral/non-invasive)
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- None specified in the document. (The CPB does not provide explicit documentation requirements such as required medical records, test results, or prior authorization criteria.)
Key Coverage Criteria
- Xerostomia (dry mouth) — This Clinical Policy Bulletin addresses xerostomia: selected treatments. (No explicit "Covered Indications" section or explicit covered interventions are provided in the document.)
1 Active Policy
AETNA-CPB-0302, Xerostomia: Selected Treatments
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.