Conversion of Anti-Coagulants to Heparin Before and After Elective Surgery

Aetna covers continuous IV heparin infusion for members on apixaban, dabigatran, edoxaban, rivaroxaban, or warfarin who need maintained anticoagulation before and after diagnostic/therapeutic procedures (HCPCS J1642/J1643/J1644/S9336 and ICD‑10 Z79.01 only covered if policy selection criteria are met). Outpatient pre‑procedure weaning is preferred; inpatient bridging is limited to up to 3 pre‑procedure days when thrombotic risk warrants it, and bridging is generally not indicated if INR <1.5.

"Conversion from apixaban to dabigatran/edoxaban/rivaroxaban: "Stop apixaban and start dabigatran/edoxaban/rivaroxaban at the time that the next scheduled dose of apixaban would be due."

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