Intestinal Rehabilitation Programs

Aetna covers multidisciplinary intestinal rehabilitation programs as medically necessary only for patients with parenteral nutrition–dependent intestinal failure when selection criteria are met (e.g., diagnoses K91.2 or Z90.49). All other indications are considered experimental/investigational (including malnutrition codes E41, E43–E46, E64.0 and Crohn’s/ulcerative colitis K50.*, K51.* not covered), and there is no specific CPT/HCPCS code.

"Aetna considers intestinal rehabilitation programs experimental and investigational for all other indications."

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